Musician’s dystonia study

SP10: Classification of endogenous and exogenous trigger factors in musician’s dystonia

Principle Investigator: Eckart Altenmüller
Co-Investigator: Alexander Schmidt

Musician’s dystonia is a task specific loss or deterioration of highly skilled movement patterns whilst playing a musical instrument. It is highly disabling and affects about 1-5 % of professional musicians. Besides genetics, several trigger factors play a role.

Cumulative life-practice time, later age of inception of playing the musical instrument but also psychological trigger factors, peripheral nerve lesions and chronic pain are risk factors. We therefore argue that the “phenotype” musician’s dystonia comprises a heterogenous group of rare disorders including overuse injuries, classical primary dystonias and anxiety disorders.

The aim of the project is to characterize the different subtypes of musician’s dystonia according to epidemiological, psychological, neurophysiological and genetic criteria. The long-term aim is to develop more effective interventions. Here, musicians serve as a model for other task-specific dystonias.

Methods: We will recruit 160 musician’s patients from our out-patient clinic. Questionnaires concerning musical biography, cumulative life practice time, trigger events, psychological conditions will be collected. Electrophysiological parameters including assessment of motor excitability, and lateral-inhibition with TMS and connectivity measures as well as resting state assessment with EEG-methods will be done. Genetic testing will be performed. According to the outcome, a classification of “genetic”, “psychological” or “overuse” type of dystonia will be possible and client tailored treatments will be initiated.

The objectives are:

To establish a novel classification of task-induced dystonias according to epidemiological, psychological, neurophysiological, and genetic criteria in order to develop more client-tailored treatments and interventions.

Main result will be more efficient treatment strategies, including behavioral and electrophysiological methods.