Journal of Hand Therapy
Volume 22, Issue 2 , Pages 144-155 , April 2009

Focal hand dystonia in musicians: phenomenology, etiology, and psychological trigger factors

  • Eckart Altenmüller

      Affiliations

    • Corresponding Author InformationCorrespondence and reprint requests to E. Altenmuller, University for Music and Drama, Hannover Institute for Music Physiology and Musicians' Medicine, Hohenzollernstrasse 47, D-30161, Hannover, Germany; Tel.: +49 511 3100 552; fax: +49 511 3100 557

Reference 

  1. Altenmüller E. Focal dystonia: advances in brain imaging and understanding of fine motor control in musicians. Hand Clin. 2003;19:523–538
  2. Nutt JG, Muenter MD, Melton LJ, Aronson A, Kurland LT. Epidemiology of dystonia in Rochester, Minnesota. Adv Neurol. 1988;50:361–365
  3. Nakashima K, Kusumi M, Inoue Y, Takahashi K. Prevalence of focal dystonias in the western area of Tottori Prefecture in Japan. Mov Disord. 1995;10:440–443
  4. Schmidt A, Jabusch HC, Altenmüller E, et al. Dominantly transmitted focal dystonia in families of patients with musicians cramp. Neurology. 2006;67:691–693
  5. Naumann M, Pirker W, Reiners K, Lange KW, Becker G, Brucke T. Imaging the pre- and postsynaptic side of striatal dopaminergic synapses in idiopathic cervical dystonia: a SPECT study using [123I] epidepride and [123I] beta-CIT. Mov Disord. 1998;13:319–323
  6. Preibisch C, Berg D, Hofmann E, Solymosi L, Naumann M. Cerebral activation patterns in patients with writer's cramp: a functional magnetic resonance imaging study. J Neurol. 2001;248:10–17
  7. Lenz FA, Byl NN. Reorganization in the cutaneous core of the human thalamic principal somatic sensory nucleus (Ventral caudal) in patients with dystonia. J Neurophysiol. 1999;82:3204–3212
  8. Delmaire C, Krainik A, Tézenas du Montcel S, et al. Disorganized somatotopy in the putamen of patients with focal hand dystonia. Neurology. 2005;64:1391–1396
  9. Byl NN, Merzenich MM, Jenkins WM. A primate genesis model of focal dystonia and repetitive strain injury: I. Learning-induced dedifferentiation of the representation of the hand in the primary somatosensory cortex in adult monkeys. Neurology. 1996;47:508–520
  10. Bara-Jiminez W, Catalan MJ, Hallett M, Gerloff C. Abnormal sensory homunculus in dystonia of the hand. Ann Neurol. 1998;44:828–831
  11. McKenzie AL, Nagarajan SS, Roberts TP, Merzenich MM, Byl NN. Somatosensory representation of the digits and clinical performance in patients with focal hand dystonia. Am J Phys Med Rehabil. 2003;82:737–749
  12. Elbert T, Candia V, Altenmüller E, et al. Alteration of digital representations in somatosensory cortex in focal hand dystonia. NeuroReport. 1998;16:3571–3575
  13. Elbert T, Pantev C, Wienbruch C, Rockstroh B, Taub E. Increased cortical representation of the fingers of the left hand in string players. Science. 1995;270:305–307
  14. Altenmüller E. From the Neanderthal to the concert hall: development of sensory motor skills and brain plasticity in music performance. In:  Williamon A,  Coimbra D editor. Proceedings of the international symposium on performance science. Utrecht: European Association of Conservatoires (AEC); 2007;p. 1–14
  15. Ragert P, Schmidt A, Altenmüller E, Dinse R. Meta-plasticity in musicians. Eur J Neurosci. 2004;19:473–478
  16. Naumann M, Magyar-Lehmann S, Reiners K, Erbguth F, Leenders KL. Sensory tricks in cervical dystonia: perceptual dysbalance of parietal cortex modulates frontal motor programming. Ann Neurol. 2000;47:322–328
  17. Jabusch HC, Altenmüller E. Epidemiology, phenomenology and therapy of musician's cramp. In:  Altenmüller E,  Kesselring J,  Wiesendanger M editor. Music, motor control and the brain. Oxford: Oxford University Press; 2006;p. 265–282
  18. Lederman RJ. Focal dystonia in instrumentalists: clinical features. Med Probl Perform Art. 1991;6:132–136
  19. Lim V, Altenmüller E. Musicians cramp: instrumental and gender differences. Med Probl Perform Art. 2003;18:21–27
  20. Schmidt A, Jabusch HC, Altenmüller E, et al. Clinical genetics of musician's dystonia: familial aggregation of dystonia and other movement disorders. Neurology, in press.
  21. Charness ME, Ross MH, Shefner JM. Ulnar neuropathy and dystonic flexion of the fourth and fifth digits: clinical correlation in musicians. Muscle Nerve. 1996;19:431–437
  22. Chamagne P. Functional dystonia in musicians: rehabilitation. Hand Clin. 2003;19:309–316
  23. Brandfonbrener AG, Robson C. A review of 111 musicians with focal dystonia seen at a performing artist's clinic 1985–2002. Mov Disord. 2002;17:1135–1138
  24. Schuele S, Lederman RJ. Focal dystonia in woodwind instrumentalists: long-term outcome. Med Probl Perform Art. 2003;18:15–20
  25. Gowers WR. A manual of diseases of the nervous system. London: Churchill; 1888;
  26. Brain WR. Diseases of the nervous system. London: Oxford University Press; 1933;
  27. Sheehy MP, Marsden CD. Writer's cramp – a focal dystonia. Brain. 1982;105:461–480
  28. Marsden CD, Sheehy MP. Writer's cramp. [Review] Trends Neurosci. 1990;13:148–153
  29. Frommer J. Idiopathic writer's cramp as a psychosomatic disorder. Z Psychosom Med. 1992;38:49–62
  30. Schulze A, Jacob HW, Guckler A. Psychosomatic determinants of writer's cramp. Psychother Psychosom Med Psychol. 1992;42:201–205
  31. Windgassen K, Ludolph A. Psychiatric aspects of writer's cramp. Eur Arch Psychiatry Clin Neurosci. 1991;241:170–176
  32. Pai MN. The nature and treatment of writer's cramp. J Ment Sci. 1947;93:68–81
  33. Gibson HB. Writer's cramp: a behavioural approach. Behav Res Ther. 1972;10:371–380
  34. Cottraux JA, Juenet C, Collet L. The treatment of writer's cramp with multimodal behaviour therapy and biofeedback: a study of 15 cases. Br J Psychiatry. 1983;142:180–183
  35. Zacher A. Writer's cramp – focal dystonia or psychogenic movement disorder? A critical literature study. [Review] Fortschr Neurol Psychat. 1989;57:328–336
  36. Ludolph AC, Windgassen K. Writer's cramp: a study of 30 cases. Nervenarzt. 1992;63:462–466
  37. Harrington RC, Wieck A, Marks IM, Marsden CD. Writer's cramp: not associated with anxiety. Mov Disord. 1988;3:195–200
  38. Gündel H, Busch R, Ceballos-Baumann AA, Seifert E. Psychiatric comorbidity in patients with spasmodic dysphonia: a controlled study. J Neurol Neurosurg Psychiatry. 2008;78:1398–1400
  39. Bugalho P, Correa B, Guimaraes J, Xavier M. Set-shifting and behavioral dysfunction in primary focal dystonia. Mov Disord. 2008;23:200–206
  40. Herrojo-Ruiz M, Senghaas P, Grossbach M, et al. Defective inhibition and inter-regional phase synchronization in pianists with musician's dystonia (MD): an EEG study. Hum Brain Mapp, in press.
  41. Rosenkranz K, Williamon A, Butler K, Cordivari C, Lees AJ, Rothwell JC. Pathophysiological differences between musicians dystonia and writers cramp. Brain. 2005;128:918–931
  42. Altenmüller E. Robert Schumann's focal dystonia. Neurological disorders on famous artists. Front Neurol Neurosci. 2005;179–188Karger, Basel
  43. Altenmüller E. The end of the song: Robert Schumann's focal dystonia. In:  Altenmüller E,  Kesselring J,  Wiesendanger M editor. Music, motor control and the brain. Oxford: Oxford University Press; 2006;p. 251–264
  44. Jabusch HC, Müller SV, Altenmüller E. Anxiety in musicians with focal dystonia and those with chronic pain. Mov Disord. 2004;19:1169–1175
  45. Jabusch HC, Altenmüller E. Anxiety as an aggravating factor during onset of focal dystonia in musicians. Med Probl Perform Art. 2004;192:75–81
  46. Newmark J, Hochberg FH. Isolated painless manual incoordination in 57 musicians. J Neurol Neurosurg Psychiatry. 1987;503:291–295
  47. Smith BH, Elliott AM, Chambers WA, Smith WC, Hannaford PC, Penny K. The impact of chronic pain in the community. Fam Pract. 2001;18:292–299
  48. Fishbein M, Middlestadt E, Ottati V, Straus S, Ellis A. Medical problems among ICSOM musicians: overview of a national survey. Med Probl Perform Art. 1988;3:1–8
  49. Fahrenberg J, Hampel R, Selg H. Das Freiburger Persoenlichkeitsinventar FPI. Revidierte Fassung FPI-R und teilweise geaenderte Fassung FPI-A1. Goettingen: Hogrefe-Verlag fuer Psychologie; 1994;
  50. Krampen G. Fragebogen zu Kompetenz- und Kontrollueberzeugungen (FKK). Goettingen: Hogrefe-Verlag fuer Psychologie; 1991;
  51. Altenmüller E. Causes et traitements de la dystonie de fonction chez les musiciens. Medicine des arts. 2001;36:19–27
  52. McGaugh JL. Memory – a century of consolidation. [Review] Science. 2000;287:248–251
  53. Sripanidkulchai K, Sripanidkulchai B, Wyss JM. The cortical projection of the basolateral amygdaloid nucleus in the rat: a retrograde fluorescent dye study. J Comp Neurol. 1984;229:419–431
  54. Craig KD. Emotional aspects of pain. In:  Wall PD,  Melzack R editor. Textbook of pain. Edinburgh: Churchill Livingstone; 1984;p. 153–161
  55. Linton SJ. A review of psychological risk factors in back and neck pain. [Review] Spine. 2000;25:1148–1156
  56. Haerkaepaeae K. Psychosocial factors as predictors for early retirement in patients with chronic low back pain. J Psychosom Res. 1992;36:553–559
  57. Harkins SW, Price DD, Braith J. Effects of extraversion and neuroticism on experimental pain, clinical pain, and illness behavior. Pain. 1989;36:209–218
  58. Jabusch HC, Altenmüller E. Focal Dystonia in musicians: from phenomenology to therapy. Adv Cogn Psychol. 2006;2:207–220

PII: S0894-1130(08)00198-1

doi: 10.1016/j.jht.2008.11.007

Journal of Hand Therapy
Volume 22, Issue 2 , Pages 144-155 , April 2009

Article Tools

* Image Usage & Resolution