title: Focal dystonia in musicians: phenomenology, pathophysiology and triggering factors.
abstract: BACKGROUND
  Musician's dystonia is a task-specific movement disorder that manifests itself as a loss of voluntary motor control in extensively trained movements. In many cases, the disorder terminates the careers of affected musicians. Approximately, 1% of all professional musicians are affected. The pathophysiology of the disorder is still unclear. Findings include: (i) reduced inhibition in different levels of the central nervous system, (ii) maladaptive plasticity, e.g. in the somatosensory cortex and in the basal ganglia and (iii) alterations in sensorimotor processing.
  
  
  METHODS
  Review of the literature.
  
  
  RESULTS
  Epidemiological data demonstrated a higher risk for those musicians who play instruments requiring maximal fine-motor skills. For instruments where workload differs across hands, focal dystonia appears more often in the more intensely used hand. In psychological studies, musicians with dystonia had more perfectionist tendencies than healthy musicians. These findings strengthen the assumption that behavioural factors may be involved in the etiology of musician's dystonia. Hereditary factors may play a greater role than previously assumed.
  
  
  CONCLUSIONS
  We propose a heuristic model that may explain the relatively high incidence of focal dystonia in musicians. This model assumes the coactions between a predominantly genetically determined predisposition and intrinsic and extrinsic triggering factors.
authors.affiliation: University for Music and Drama, Hannover, Institute for Music Physiology and Musicians Medicine, Hannover, Germany. altenmueller@hmt-hannover.de
authors.forename: E
authors.initials: E
authors.lastname: Altenmüller
authors.forename: H-C
authors.initials: HC
authors.lastname: Jabusch
mesh_terms: D020821:Dystonic Disorders / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D009146:Music; D011597:Psychomotor Performance / Q000502:physiology