title: Musician's cramp as manifestation of maladaptive brain plasticity: arguments from instrumental differences.
abstract: Musician's cramp is a task-specific movement disorder that presents itself as muscular incoordination or loss of voluntary motor control of extensively trained movements while a musician is playing the instrument. It is characterized by task specificity and gender bias, affecting significantly more males than females. The etiology is multifaceted: a combination of a genetic predisposition, termed endophenotype, and behavioral triggering factors being the leading features for the manifestation of the disorder. We present epidemiological data from 591 musician patients from our outpatient clinic demonstrating an influence of fine-motor requirements on the manifestation of dystonia. Brass, guitar, and woodwind players were at greater risk than other instrumentalists. High temporospatial precision of movement patterns, synchronous demands on tonic and phasic muscular activation, in combination with fine-motor burdens of using the dominant hand in daily life activities, constitute as triggering factors for the disorder and may explain why different body parts are affected.
authors.affiliation: Institute for Music Physiology and Musicians' Medicine, University of Music, Drama and Media, Hannover, Germany. eckart.altenmueller@hmtm-hannover.de
authors.forename: Eckart
authors.initials: E
authors.lastname: Altenmüller
authors.forename: Volker
authors.initials: V
authors.lastname: Baur
authors.forename: Aurélie
authors.initials: A
authors.lastname: Hofmann
authors.forename: Vanessa K
authors.initials: VK
authors.lastname: Lim
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Jabusch
mesh_terms: D001921:Brain / Q000503:physiopathology; D016022:Case-Control Studies; D020821:Dystonic Disorders / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000502:physiology; D009146:Music / Q000523:psychology; D009473:Neuronal Plasticity / Q000502:physiology; D009488:Neurosciences; D012307:Risk Factors; D012727:Sex Characteristics; D013647:Task Performance and Analysis