title: Sonographic alteration of lenticular nucleus in focal task-specific dystonia of musicians.
abstract: OBJECTIVE
  In distinct movement disorders, transcranial sonography detects alterations of deep brain structures with higher sensitivity than other neuroimaging methods. Lenticular nucleus hyperechogenicity on transcranial sonography, thought to be caused by increased local copper content, has been reported as a characteristic finding in primary spontaneous dystonia. Here, we wanted to find out whether deep brain structures are altered in task-specific dystonia.
  
  
  METHODS
  The frequency of sonographic brainstem and basal ganglia changes was studied in an investigator-blinded setting in 15 musicians with focal task-specific hand dystonia, 15 musicians without dystonia, and 15 age- and sex-matched nonmusicians without dystonia.
  
  
  RESULTS
  Lenticular nucleus hyperechogenicity was found in 12 musicians with task-specific dystonia, but only in 3 nondystonic musicians (Fisher's exact test, p = 0.001) and 2 nonmusicians (p < 0.001). The degree of lenticular nucleus hyperechogenicity in affected musicians correlated with age, but not with duration of music practice or duration of dystonia. In 2 of 3 affected musicians with normal echogenic lenticular nucleus, substantia nigra hyperechogenicity was found.
  
  
  CONCLUSIONS
  Our findings support the idea of a pathogenetic link between primary spontaneous and task-specific dystonia. Sonographic basal ganglia alteration might indicate a risk factor that in combination with extensive fine motor training promotes the manifestation of task-specific dystonia.
authors.affiliation: Department of Neurology, University of Rostock, Rostock, Germany. uwe.walter@med.uni-rostock.de
authors.forename: Uwe
authors.initials: U
authors.lastname: Walter
authors.forename: Franziska
authors.initials: F
authors.lastname: Buttkus
authors.forename: Reiner
authors.initials: R
authors.lastname: Benecke
authors.forename: Annette
authors.initials: A
authors.lastname: Grossmann
authors.forename: Dirk
authors.initials: D
authors.lastname: Dressler
authors.forename: Eckart
authors.initials: E
authors.lastname: Altenmüller
mesh_terms: D000328:Adult; D003342:Corpus Striatum / Q000000981:diagnostic imaging* / Q000473:pathology*; D004421:Dystonia / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009146:Music; D017585:Ultrasonography, Doppler, Transcranial