title: Objective Evaluation of Performance Stress in Musicians With Focal Hand Dystonia: A Case Series.
abstract: Five musicians suffering from focal dystonia participated in a pilot study that examined the feasibility of an experimental protocol designed to assess musicians' motor performance under stress. Electrocardiography, free cortisol levels, and subjective assessments were used to monitor alterations of the hypothalamic-pituitary-adrenal axis. As measures of motor outcome, temporal variability of finger movements and muscular cocontraction of the wrist flexor and extensor were assessed. Findings suggest that the specific experimental design could be successfully applied. Several methodological issues such as carryover effects, the use of free cortisol, the inclusion of a double baseline, and the classification of dystonic patients into stress responders and nonresponders are analyzed and discussed.
authors.affiliation: a Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media , Hanover , Germany.
authors.forename: Christos I
authors.initials: CI
authors.lastname: Ioannou
authors.affiliation: b Department of Information and Communication Science , Sophia University , Tokyo , Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Furuya
authors.affiliation: a Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media , Hanover , Germany.
authors.forename: Eckart
authors.initials: E
authors.lastname: Altenmüller
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D020821:Dystonic Disorders / Q000150:complications / Q000378:metabolism / Q000503:physiopathology / Q000523:psychology*; D005385:Fingers / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D009119:Muscle Contraction / Q000502:physiology; D010865:Pilot Projects; D010913:Pituitary-Adrenal System / Q000378:metabolism / Q000503:physiopathology; D011597:Psychomotor Performance / Q000502:physiology*; D012463:Saliva / Q000378:metabolism; D013315:Stress, Psychological / Q000150:complications / Q000378:metabolism / Q000523:psychology*; D014953:Wrist / Q000502:physiology
chemical_list: D006854:Hydrocortisone
keywords: electrophysiology; focal dystonia; free cortisol; motor performance; stress