title: Sensorimotor skills and focal dystonia are linked to putaminal grey-matter volume in pianists.
abstract: BACKGROUND
  Focal hand dystonia has been associated with morphometric changes and distorted somatotopic representations in the putamen.
  
  
  OBJECTIVE
  The authors used voxel-based morphometry (VBM) to identify regions in the putamen where grey-matter volume is associated with musician's dystonia (MD) or the skill level of piano playing in professional pianists.
  
  
  METHODS
  In 11 pianists with MD affecting the right hand and 12 healthy pianists without dystonia, the authors performed high-resolution T1-weighted MRI of the brain. The authors also measured the temporal variability of key strokes during scale playing with the right hand to characterise the individual skill level of piano playing. Statistical comparisons of the normalised and smoothed grey-matter maps were performed to test for dystonia and performance-related structural changes in the putamen.
  
  
  RESULTS
  During scale playing, the timing of consecutive key strokes was more variable in MD patients than in non-dystonic pianists. Regional grey-matter volume in the middle part of left and right putamen increased with timing variability during piano playing in pianists with and without MD. Between-group comparisons revealed that MD patients had a larger grey-matter volume in the right middle putamen compared with healthy musicians.
  
  
  CONCLUSIONS
  In highly trained pianists with and without MD, the volume of the associative motor territory in the middle putamen reflects both the skill level of piano playing and the presence of dystonia. While a smaller volume is associated with better timing skills, a relative expansion is correlated with the presence of focal task-specific hand dystonia.
authors.affiliation: Department of Neurology, University Hospital Schleswig-Holstein, Kiel Campus, Arnold-Heller-Str 3, Building No 41, Kiel D-24105, Germany. o.granert@neurologie.uni-kiel.de
authors.forename: Oliver
authors.initials: O
authors.lastname: Granert
authors.forename: Martin
authors.initials: M
authors.lastname: Peller
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Jabusch
authors.forename: Eckart
authors.initials: E
authors.lastname: Altenmüller
authors.forename: Hartwig Roman
authors.initials: HR
authors.lastname: Siebner
mesh_terms: D000328:Adult; D000368:Aged; D001931:Brain Mapping / Q000379:methods; D020821:Dystonic Disorders / Q000175:diagnosis*; D005260:Female; D006225:Hand; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology / Q000503:physiopathology*; D009048:Motor Skills / Q000502:physiology*; D009146:Music; D011597:Psychomotor Performance / Q000502:physiology*; D011699:Putamen / Q000502:physiology*