Conti Anna M, Pullman Seth, Frucht Steven J
The Neurological Institute, Columbia University Medical Center, New York, New York, USA.
Mov Disord. 2008 Jul 30;23(10):1398-406. doi: 10.1002/mds.21976.
Focal task-specific dystonia of the musicians' hand (FTSDmh) is an occupational movement disorder that affects instrumental musicians and often derails careers. There has been speculation on the role of intense practice or the specific technical demands of various instruments as triggers for the development of FTSDmh. In this study, we review the clinical features of all published cases (899 patients) and 61 previously unpublished cases of FTSDmh. Our primary goals were to search for patterns in the clinical phenotype, and to discern if specific instrumental technical demands might be related to the development of dystonia. Symptoms of FTSDmh began at a mean age 35.7 years (SD = 10.6), with an overwhelming male predominance (M:F = 4.1:1). The right hand was preferentially affected in keyboard and plucked string players (77%), and the left hand in bowed string players (68%). Flexion movements were the most common dystonic movement in each instrument class, and fingers 3, 4, and 5, either in isolation or combination, were most frequently involved. The clinical implications of these findings and their possible relationship to the pathophysiology of focal task-specific dystonia are explored.
音乐家手部局灶性任务特异性肌张力障碍（FTSDmh）是一种职业性运动障碍，影响乐器演奏者，常常使他们的职业生涯受挫。对于高强度练习或各种乐器的特定技术要求作为FTSDmh发病诱因的作用，一直存在猜测。在本研究中，我们回顾了所有已发表病例（899例患者）以及61例此前未发表的FTSDmh病例的临床特征。我们的主要目标是寻找临床表型中的模式，并辨别特定乐器技术要求是否可能与肌张力障碍的发病有关。FTSDmh症状开始出现的平均年龄为35.7岁（标准差=10.6），男性占压倒性多数（男：女=4.1:1）。在键盘乐器和拨弦乐器演奏者中，右手更易受累（77%），而在弓弦乐器演奏者中，左手更易受累（68%）。在每种乐器类型中，屈曲运动是最常见的肌张力障碍运动，第3、4和5指单独或合并受累最为频繁。本文探讨了这些发现的临床意义及其与局灶性任务特异性肌张力障碍病理生理学的可能关系。
