Challenges of Making Music: What Causes Musician’s Dystonia?

Schmidt, Alexander; Jabusch, Hans‐Christian; Altenmüller, Eckart; Kasten, Meike; Klein, Christine

doi:10.1001/jamaneurol.2013.3931

Cited by 35 publications

(31 citation statements)

References 5 publications

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“…A t test yielded a significant difference between these two groups ( P = 0.0045), confirming a previous observation that patients with MD initiated musical training at a later age than did healthy musicians (Schmidt et al . ).…”

Section: Resultsmentioning

confidence: 97%

Aberrant cortical excitability reflects the loss of hand dexterity in musician's dystonia

Furuya

Uehara

Sakamoto

et al. 2018

The Journal of Physiology

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Focal task-specific dystonia (FTSD) compromises dexterous movements. A proposed pathophysiological mechanism of FTSD involves malfunction of the motor cortex (M1). However, no evidence is yet available regarding whether and how malfunctions of M1 are responsible for the loss of motor dexterity. Here, we addressed this issue by assessing both M1 excitability and detailed movement parameters, as well as their relationships. Transcranial magnetic stimulation was applied over M1 in 20 pianists with FTSD, 20 healthy pianists and 20 non-musicians. The patients demonstrated both reduced short-interval intracortical inhibition (SICI) and elevated intracortical facilitation (ICF) compared with the healthy controls. This indicates that the abnormal cortical excitability reflects pathophysiology but not current skills. Hand motor dexterity was evaluated by position sensors during piano playing at two tempi. The patients showed delayed transition from finger flexion to extension at the fastest tempo and greater timing variability of the finger movements. Furthermore, multivariate analyses identified distinct sets of covariation between cortical excitability and dexterity measures. Namely, the SICI measure and ICF measure were associated with the temporal variability of the movements and the quickness of the transition from flexion to extension, respectively. Specifically, the reduced inhibition and elevated facilitation at M1 in pianists was related to the temporal imprecision and impairment of quick transitions in the sequential finger movements. The present study provides novel evidence associating M1 malfunctions with dexterity loss.

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Section: Resultsmentioning

confidence: 97%

Aberrant cortical excitability reflects the loss of hand dexterity in musician's dystonia

Furuya

Uehara

Sakamoto

et al. 2018

The Journal of Physiology

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“…The robustness of neuroplasticity of early-beginning pianists thus predicts their low risk of occurrence of focal dystonia. Indeed, a recent study identified that musician who commenced musical training before the age seven showed lower risk of focal dystonia [35]. …”

Section: Discussionmentioning

confidence: 99%

Early optimization in finger dexterity of skilled pianists: implication of transcranial stimulation

et al. 2013

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BackgroundIt has been shown that non-invasive transcranial direct current stimulation (tDCS) facilitates motor functions in healthy adults and stroke patients. However, little is known about neuroplastic changes induced by tDCS in highly-trained individuals. Here we addressed this issue by assessing the effect of tDCS on dexterity of finger movements in healthy adult pianists. Twelve pianists practiced bimanual keystrokes in an in-phase manner while bilateral tDCS (left anodal/right cathodal or vice versa) of the primary motor cortex was performed. Before and after stimulation, each participant was asked to perform the trained successive keystrokes, and to repetitively strike a key with each of the fingers as fast and accurate as possible while keeping the remaining fingers immobilized voluntarily.ResultsIn contrast to previous findings in untrained individuals, tDCS yielded overall no apparent improvement of fine control of finger movements in the professional pianists. However, for some movement features, pianists who commenced training at later age demonstrated larger improvements of fine motor control following tDCS.ConclusionsThese findings, in combination with lack of any correlation between the age at which pianists commenced the training and motor improvements for sham stimulation conditions, supports the idea that selectively late-started players benefit from tDCS, which we interpret as early optimization of neuroplasticity of the motor system.

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“…The etiology of FTSD remains unknown, although recent lines of evidence suggest that both genetic and environmental factors are important [17]. Examination of family members of patients with FTSD revealed up to 25% of patients with an affected family member [18, 19].…”

Section: Advances In Understandingmentioning

confidence: 99%

“…Possible risk factors include personality traits, such as perfectionism and anxiety, anatomical factors, such as hand size and joint mobility, as well as delayed onset of age of musical training [17, 24, 25]. …”

Section: Advances In Understandingmentioning

confidence: 99%

Focal task specific dystonia: a review and update

Stahl

Frucht

2016

J Neurol

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In this review, we summarize recent advances in understanding the etiology, risk factors and pathophysiology of focal task specific dystonia (FTSD), movement disorders characterized by abnormal motor activation during the performance of specific, repetitive actions. We focus on two common FTSD, musician’s dystonia and writer’s cramp. FTSD may pose a threat to the patient’s livelihood, and improved therapeutic treatments are needed.

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Challenges of Making Music: What Causes Musician’s Dystonia?

Cited by 35 publications

References 5 publications

Aberrant cortical excitability reflects the loss of hand dexterity in musician's dystonia

Aberrant cortical excitability reflects the loss of hand dexterity in musician's dystonia

Early optimization in finger dexterity of skilled pianists: implication of transcranial stimulation

Focal task specific dystonia: a review and update

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