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Eckart Altenmuller - One of the best experts on this subject based on the ideXlab platform.
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From the Neanderthal to the concert hall: Development of sensory motor skills and brain plasticity in music performance
2020Co-Authors: Eckart AltenmullerAbstract:For thousands of years, humans have striven to express and communicate their feelings by singing and playing musical instruments. In order to create new sounds, instruments were invented requiring novel and frequently complex movement patterns. Sensory-motor skills of Musicians have some specific qualities: learning begins at an early age in a playful atmosphere. Routines for stereotyped movements are rehearsed for extended periods of time with gradually increasing degrees of complexity. Via auditory feedback, the motor performance is extremely controllable by both performer and audience. These specific circumstances seem to play an important role for plastic adaptations of the central nervous system. Training-induced changes include both brain function and brain structure and can be observed in sensory-motor and auditory networks. However, in the last two centuries increasing specialization and, as a consequence, prolonged training have produced dysfunctional adaptations of the brain, leading to secondary deterioration of movement patterns referred to as Musicians’ Dystonia. This disorder could mark the final point of human evolution of sensory motor skills.
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elevated forearm coactivation levels and higher temporal variability in string players with Musicians Dystonia during demanding playing conditions
Medical Problems of Performing Artists, 2020Co-Authors: F Worschech, M Grosbach, B Blasing, Eckart AltenmullerAbstract:AIMS: There is a lack of an objective measurement tool for evaluating the quality of bowing performance in string players. The present study aimed to assess kinematic features of bow strokes performed by violinists and violists affected by bow arm Dystonia, compared to healthy controls. METHODS: Seven Musicians with musician's Dystonia and 20 healthy controls participated in the study. A 3D motion capture system was used to record repetitive bowing on a single string at fixed velocities. Temporal variability, an indirect indicator for motor disturbances, was computed in order to evaluate the Musicians' performance during the repetitive movements. Simultaneously, muscular activity of essential flexors and extensors of the right arm was recorded using surface electromyography. Antagonistic muscular coactivation and temporal variability were analyzed in a multilevel linear model framework. RESULTS: The results revealed generally higher forearm coactivation during upstrokes as compared to downstrokes in both groups. Whereas coactivation levels of the upper arm did not significantly differ between groups, we found increased forearm coactivation in patients during the more demanding playing conditions. Increased coactivation may represent an adaptive motor control strategy that is applied in order to reduce noise entering the motor system. Furthermore, affected Musicians executed bow strokes with higher temporal variability than healthy controls, especially during fast playing. CONCLUSIONS: Building on these results we introduce a novel approach using simple kinematic measures to quantifying dystonic symptoms in string players. Even though Dystonia patients showed higher temporal variability and elevated forearm coactivation, both variables were not correlated. This finding is discussed with respect to the heterogeneity of Musicians' Dystonia and its individual-specific manifestations in dystonic symptoms.
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aberrant somatosensory motor adaptation in Musicians Dystonia
Movement Disorders, 2020Co-Authors: Shinichi Furuya, Eckart AltenmullerAbstract:BACKGROUND: Some forms of movement disorders are characterized by task-specific manifestations of symptoms. However, its underlying mechanisms are poorly understood. Here we addressed this issue through a novel motor adaptation experimental paradigm. METHODS: Pianists with and without focal task-specific Dystonia learned to play the piano with a key whose weight can be modified by a novel robot system. RESULTS: The result clearly demonstrated a significantly larger error between the target and produced keystroke velocities in the patients than the controls following a repetition of keystrokes of the weighted key. This adaptation failure was not correlated with the variability of timing and velocity of the keystroke when the patients were playing unloaded piano keys, which suggests distinct effects of focal task-specific Dystonia on motor adaptation and fine motor control. Immediately after a repetition of the strikes of the heavy key with keeping the fingers adducted, the error of the keystroke velocity when striking the key with the fingers more abducted was maintained in both the patients and controls. This generalization of the adaptation across different hand postures suggests that motor memory of dynamics of the piano key is independent of biomechanical properties of the hand. Importantly, a lack of difference in the finger muscular strength between the groups indicated that the adaptation failure was not attributed to deficit of muscular strength in the patients. CONCLUSIONS: These findings suggest that task-specific manifestation of dystonic movements in focal task-specific Dystonia is associated with malfunctions of internal representation of mechanical properties of a well-trained tool. (c) 2020 International Parkinson and Movement Disorder Society.
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Aberrant somatosensory–motor adaptation in Musicians' Dystonia
Movement Disorders, 2020Co-Authors: Shinichi Furuya, Eckart AltenmullerAbstract:BACKGROUND: Some forms of movement disorders are characterized by task-specific manifestations of symptoms. However, its underlying mechanisms are poorly understood. Here we addressed this issue through a novel motor adaptation experimental paradigm. METHODS: Pianists with and without focal task-specific Dystonia learned to play the piano with a key whose weight can be modified by a novel robot system. RESULTS: The result clearly demonstrated a significantly larger error between the target and produced keystroke velocities in the patients than the controls following a repetition of keystrokes of the weighted key. This adaptation failure was not correlated with the variability of timing and velocity of the keystroke when the patients were playing unloaded piano keys, which suggests distinct effects of focal task-specific Dystonia on motor adaptation and fine motor control. Immediately after a repetition of the strikes of the heavy key with keeping the fingers adducted, the error of the keystroke velocity when striking the key with the fingers more abducted was maintained in both the patients and controls. This generalization of the adaptation across different hand postures suggests that motor memory of dynamics of the piano key is independent of biomechanical properties of the hand. Importantly, a lack of difference in the finger muscular strength between the groups indicated that the adaptation failure was not attributed to deficit of muscular strength in the patients. CONCLUSIONS: These findings suggest that task-specific manifestation of dystonic movements in focal task-specific Dystonia is associated with malfunctions of internal representation of mechanical properties of a well-trained tool. (c) 2020 International Parkinson and Movement Disorder Society.
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p040 restoration of abnormal muscular cramping in Musicians Dystonia through bihemispheric transcranial direct current stimulation and bimanual motor retraining
Clinical Neurophysiology, 2017Co-Authors: Shinichi Furuya, M Nitsche, Walter Paulus, Eckart AltenmullerAbstract:Question Task-specific focal Dystonia (TSFD) is typically characterized by involuntary and abnormal muscular cramping, which compromises fine motor control. Previous neurophysiological studies have identified loss of inhibitory control at the motor cortex as a possible pathophysiology of the dystonic cramping. A recent study demonstrated that bi-hemispheric transcranial direct current stimulation (tDCS) over the motor cortices during performing bimanual mirrored finger movements ameliorated impairment of dexterous finger movements in pianists with TSFD. However, little has been uncovered about its underlying neurophysiological mechanism. Here we tested a hypothesis that the bi-hemispheric tDCS with motor retraining normalizes abnormal co-contraction between antagonistic pairs of extrinsic finger muscles in pianists with TSFD. Methods Eight pianists suffering from TSFD at the right hand and eight healthy pianists performed the bimanual mirrored finger movements for twenty-four minutes with two conditions; either with 2 mA tDCS over the motor cortices (cathodal over the left and anodal over the right) for twenty-four minutes (real condition) or thirty seconds (sham condition). Results The results demonstrated changes in pattern of muscular co-contraction only following the real stimulation condition, in which tonic activity turned into more phasic pattern. In addition, the amount of muscular co-contraction was significantly decreased after the real stimulation in the patients, which was the case neither at the sham condition of the patients nor at both conditions of the healthy controls. Conclusions The results provide physiological evidences of restoration of both abnormal pattern and amount of muscular co-activation of Musicians’ Dystonia through the bi-hemispheric tDCS with bimanual motor retraining.
Shinichi Furuya - One of the best experts on this subject based on the ideXlab platform.
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Aberrant somatosensory–motor adaptation in Musicians' Dystonia
Movement Disorders, 2020Co-Authors: Shinichi Furuya, Eckart AltenmullerAbstract:BACKGROUND: Some forms of movement disorders are characterized by task-specific manifestations of symptoms. However, its underlying mechanisms are poorly understood. Here we addressed this issue through a novel motor adaptation experimental paradigm. METHODS: Pianists with and without focal task-specific Dystonia learned to play the piano with a key whose weight can be modified by a novel robot system. RESULTS: The result clearly demonstrated a significantly larger error between the target and produced keystroke velocities in the patients than the controls following a repetition of keystrokes of the weighted key. This adaptation failure was not correlated with the variability of timing and velocity of the keystroke when the patients were playing unloaded piano keys, which suggests distinct effects of focal task-specific Dystonia on motor adaptation and fine motor control. Immediately after a repetition of the strikes of the heavy key with keeping the fingers adducted, the error of the keystroke velocity when striking the key with the fingers more abducted was maintained in both the patients and controls. This generalization of the adaptation across different hand postures suggests that motor memory of dynamics of the piano key is independent of biomechanical properties of the hand. Importantly, a lack of difference in the finger muscular strength between the groups indicated that the adaptation failure was not attributed to deficit of muscular strength in the patients. CONCLUSIONS: These findings suggest that task-specific manifestation of dystonic movements in focal task-specific Dystonia is associated with malfunctions of internal representation of mechanical properties of a well-trained tool. (c) 2020 International Parkinson and Movement Disorder Society.
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aberrant somatosensory motor adaptation in Musicians Dystonia
Movement Disorders, 2020Co-Authors: Shinichi Furuya, Eckart AltenmullerAbstract:BACKGROUND: Some forms of movement disorders are characterized by task-specific manifestations of symptoms. However, its underlying mechanisms are poorly understood. Here we addressed this issue through a novel motor adaptation experimental paradigm. METHODS: Pianists with and without focal task-specific Dystonia learned to play the piano with a key whose weight can be modified by a novel robot system. RESULTS: The result clearly demonstrated a significantly larger error between the target and produced keystroke velocities in the patients than the controls following a repetition of keystrokes of the weighted key. This adaptation failure was not correlated with the variability of timing and velocity of the keystroke when the patients were playing unloaded piano keys, which suggests distinct effects of focal task-specific Dystonia on motor adaptation and fine motor control. Immediately after a repetition of the strikes of the heavy key with keeping the fingers adducted, the error of the keystroke velocity when striking the key with the fingers more abducted was maintained in both the patients and controls. This generalization of the adaptation across different hand postures suggests that motor memory of dynamics of the piano key is independent of biomechanical properties of the hand. Importantly, a lack of difference in the finger muscular strength between the groups indicated that the adaptation failure was not attributed to deficit of muscular strength in the patients. CONCLUSIONS: These findings suggest that task-specific manifestation of dystonic movements in focal task-specific Dystonia is associated with malfunctions of internal representation of mechanical properties of a well-trained tool. (c) 2020 International Parkinson and Movement Disorder Society.
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p040 restoration of abnormal muscular cramping in Musicians Dystonia through bihemispheric transcranial direct current stimulation and bimanual motor retraining
Clinical Neurophysiology, 2017Co-Authors: Shinichi Furuya, M Nitsche, Walter Paulus, Eckart AltenmullerAbstract:Question Task-specific focal Dystonia (TSFD) is typically characterized by involuntary and abnormal muscular cramping, which compromises fine motor control. Previous neurophysiological studies have identified loss of inhibitory control at the motor cortex as a possible pathophysiology of the dystonic cramping. A recent study demonstrated that bi-hemispheric transcranial direct current stimulation (tDCS) over the motor cortices during performing bimanual mirrored finger movements ameliorated impairment of dexterous finger movements in pianists with TSFD. However, little has been uncovered about its underlying neurophysiological mechanism. Here we tested a hypothesis that the bi-hemispheric tDCS with motor retraining normalizes abnormal co-contraction between antagonistic pairs of extrinsic finger muscles in pianists with TSFD. Methods Eight pianists suffering from TSFD at the right hand and eight healthy pianists performed the bimanual mirrored finger movements for twenty-four minutes with two conditions; either with 2 mA tDCS over the motor cortices (cathodal over the left and anodal over the right) for twenty-four minutes (real condition) or thirty seconds (sham condition). Results The results demonstrated changes in pattern of muscular co-contraction only following the real stimulation condition, in which tonic activity turned into more phasic pattern. In addition, the amount of muscular co-contraction was significantly decreased after the real stimulation in the patients, which was the case neither at the sham condition of the patients nor at both conditions of the healthy controls. Conclusions The results provide physiological evidences of restoration of both abnormal pattern and amount of muscular co-activation of Musicians’ Dystonia through the bi-hemispheric tDCS with bimanual motor retraining.
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surmounting retraining limits in Musicians Dystonia by transcranial stimulation
Annals of Neurology, 2014Co-Authors: Shinichi Furuya, Walter Paulus, Michael A Nitsche, Eckart AltenmullerAbstract:Objective Abnormal cortical excitability is evident in various movement disorders that compromise fine motor control. Here we tested whether skilled finger movements can be restored in Musicians with focal hand Dystonia through behavioral training assisted by transcranial direct current stimulation to the motor cortex of both hemispheres. Methods The bilateral motor cortices of 20 pianists (10 with focal Dystonia, 10 healthy controls) were electrically stimulated noninvasively during bimanual mirrored finger movements. Results We found improvement in the rhythmic accuracy of sequential finger movements with the affected hand during and after cathodal stimulation over the affected cortex and simultaneous anodal stimulation over the unaffected cortex. The improvement was retained 4 days after intervention. Neither a stimulation with the reversed montage of electrodes nor sham stimulation yielded any improvement. Furthermore, the amount of improvement was positively correlated with the severity of the symptoms. Bihemispheric stimulation without concurrent motor training failed to improve fine motor control, underlining the importance of combined retraining and stimulation for restoring the dystonic symptoms. For the healthy pianists, none of the stimulation protocols enhanced movement accuracy. Interpretation These results suggest a therapeutic potential of behavioral training assisted by bihemispheric, noninvasive brain stimulation in restoring fine motor control in focal Dystonia. ANN NEUROL 2014;75:700–707
Walter Paulus - One of the best experts on this subject based on the ideXlab platform.
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p040 restoration of abnormal muscular cramping in Musicians Dystonia through bihemispheric transcranial direct current stimulation and bimanual motor retraining
Clinical Neurophysiology, 2017Co-Authors: Shinichi Furuya, M Nitsche, Walter Paulus, Eckart AltenmullerAbstract:Question Task-specific focal Dystonia (TSFD) is typically characterized by involuntary and abnormal muscular cramping, which compromises fine motor control. Previous neurophysiological studies have identified loss of inhibitory control at the motor cortex as a possible pathophysiology of the dystonic cramping. A recent study demonstrated that bi-hemispheric transcranial direct current stimulation (tDCS) over the motor cortices during performing bimanual mirrored finger movements ameliorated impairment of dexterous finger movements in pianists with TSFD. However, little has been uncovered about its underlying neurophysiological mechanism. Here we tested a hypothesis that the bi-hemispheric tDCS with motor retraining normalizes abnormal co-contraction between antagonistic pairs of extrinsic finger muscles in pianists with TSFD. Methods Eight pianists suffering from TSFD at the right hand and eight healthy pianists performed the bimanual mirrored finger movements for twenty-four minutes with two conditions; either with 2 mA tDCS over the motor cortices (cathodal over the left and anodal over the right) for twenty-four minutes (real condition) or thirty seconds (sham condition). Results The results demonstrated changes in pattern of muscular co-contraction only following the real stimulation condition, in which tonic activity turned into more phasic pattern. In addition, the amount of muscular co-contraction was significantly decreased after the real stimulation in the patients, which was the case neither at the sham condition of the patients nor at both conditions of the healthy controls. Conclusions The results provide physiological evidences of restoration of both abnormal pattern and amount of muscular co-activation of Musicians’ Dystonia through the bi-hemispheric tDCS with bimanual motor retraining.
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surmounting retraining limits in Musicians Dystonia by transcranial stimulation
Annals of Neurology, 2014Co-Authors: Shinichi Furuya, Walter Paulus, Michael A Nitsche, Eckart AltenmullerAbstract:Objective Abnormal cortical excitability is evident in various movement disorders that compromise fine motor control. Here we tested whether skilled finger movements can be restored in Musicians with focal hand Dystonia through behavioral training assisted by transcranial direct current stimulation to the motor cortex of both hemispheres. Methods The bilateral motor cortices of 20 pianists (10 with focal Dystonia, 10 healthy controls) were electrically stimulated noninvasively during bimanual mirrored finger movements. Results We found improvement in the rhythmic accuracy of sequential finger movements with the affected hand during and after cathodal stimulation over the affected cortex and simultaneous anodal stimulation over the unaffected cortex. The improvement was retained 4 days after intervention. Neither a stimulation with the reversed montage of electrodes nor sham stimulation yielded any improvement. Furthermore, the amount of improvement was positively correlated with the severity of the symptoms. Bihemispheric stimulation without concurrent motor training failed to improve fine motor control, underlining the importance of combined retraining and stimulation for restoring the dystonic symptoms. For the healthy pianists, none of the stimulation protocols enhanced movement accuracy. Interpretation These results suggest a therapeutic potential of behavioral training assisted by bihemispheric, noninvasive brain stimulation in restoring fine motor control in focal Dystonia. ANN NEUROL 2014;75:700–707
Steven J Frucht - One of the best experts on this subject based on the ideXlab platform.
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treatment of Musicians Dystonia
2019Co-Authors: Steven J FruchtAbstract:Musicians’ Dystonia is an example of a focal task-specific Dystonia, i.e., Dystonia affecting one part of the body, only when it is engaged in performance of a specific task. Musicians’ Dystonia may involve the upper extremity (either the hand, arm, or shoulder) or the embouchure (the muscles of lower face, tongue, and pharynx that control the flow of air into a brass or woodwind instrument). Musicians’ Dystonia typically affects professionals at the peak of their performing careers, often with devastating consequences. Recent work has revealed that both genetic and environmental influences contribute to the development of the condition. Current treatments for Musicians’ Dystonia include instrument modification, physical therapy, oral medication, injection of botulinum toxin, and even stereotactic surgery. Management remains challenging, and there is a need for more innovative approaches for treatment.
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Motor and Sensory Dysfunction in Musician's Dystonia
Current Neuropharmacology, 2013Co-Authors: Florence C.f. Chang, Steven J FruchtAbstract:Musicians’ Dystonia is a task-specific and painless loss of motor control in a previously well-executed task. It is increasingly recognized in the medical and musical community. Recent advances in neuroimaging, transcranial magnetic stimulation and novel techniques in electroencephalography have shed light on its underlying pathophysiology. To date, a deranged cortical plasticity leading to abnormal sensorimotor integration, combined with reduced inhibition across several levels of the motor pathway are likely mechanisms.This paper reviews the various phenomenology of musician’s Dystonia across keyboard, string, brass, flute and drum players. Treatment is often challenging. Medical therapies like botulinum toxin injection and rehabilitation method with sensorimotor training offer symptomatic relief and return to baseline performance to some Musicians.
Michael A Nitsche - One of the best experts on this subject based on the ideXlab platform.
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surmounting retraining limits in Musicians Dystonia by transcranial stimulation
Annals of Neurology, 2014Co-Authors: Shinichi Furuya, Walter Paulus, Michael A Nitsche, Eckart AltenmullerAbstract:Objective Abnormal cortical excitability is evident in various movement disorders that compromise fine motor control. Here we tested whether skilled finger movements can be restored in Musicians with focal hand Dystonia through behavioral training assisted by transcranial direct current stimulation to the motor cortex of both hemispheres. Methods The bilateral motor cortices of 20 pianists (10 with focal Dystonia, 10 healthy controls) were electrically stimulated noninvasively during bimanual mirrored finger movements. Results We found improvement in the rhythmic accuracy of sequential finger movements with the affected hand during and after cathodal stimulation over the affected cortex and simultaneous anodal stimulation over the unaffected cortex. The improvement was retained 4 days after intervention. Neither a stimulation with the reversed montage of electrodes nor sham stimulation yielded any improvement. Furthermore, the amount of improvement was positively correlated with the severity of the symptoms. Bihemispheric stimulation without concurrent motor training failed to improve fine motor control, underlining the importance of combined retraining and stimulation for restoring the dystonic symptoms. For the healthy pianists, none of the stimulation protocols enhanced movement accuracy. Interpretation These results suggest a therapeutic potential of behavioral training assisted by bihemispheric, noninvasive brain stimulation in restoring fine motor control in focal Dystonia. ANN NEUROL 2014;75:700–707
