University for Music and Drama, Hannover, Institute for Music Physiology and Musicians Medicine, Hannover, Germany.
Eur J Neurol. 2010 Jul;17 Suppl 1:31-6. doi: 10.1111/j.1468-1331.2010.03048.x.
Musician's dystonia is a task-specific movement disorder that manifests itself as a loss of voluntary motor control in extensively trained movements. In many cases, the disorder terminates the careers of affected musicians. Approximately, 1% of all professional musicians are affected. The pathophysiology of the disorder is still unclear. Findings include: (i) reduced inhibition in different levels of the central nervous system, (ii) maladaptive plasticity, e.g. in the somatosensory cortex and in the basal ganglia and (iii) alterations in sensorimotor processing.
Review of the literature.
Epidemiological data demonstrated a higher risk for those musicians who play instruments requiring maximal fine-motor skills. For instruments where workload differs across hands, focal dystonia appears more often in the more intensely used hand. In psychological studies, musicians with dystonia had more perfectionist tendencies than healthy musicians. These findings strengthen the assumption that behavioural factors may be involved in the etiology of musician's dystonia. Hereditary factors may play a greater role than previously assumed.
We propose a heuristic model that may explain the relatively high incidence of focal dystonia in musicians. This model assumes the coactions between a predominantly genetically determined predisposition and intrinsic and extrinsic triggering factors.
音乐家手痉挛是一种特定于任务的运动障碍，表现为在广泛训练的运动中失去自愿运动控制。在许多情况下，这种疾病会使受影响的音乐家的职业生涯结束。大约有 1%的职业音乐家受到影响。该疾病的病理生理学仍不清楚。研究结果包括：（i）中枢神经系统不同水平的抑制减少，（ii）适应性不良的可塑性，例如在躯体感觉皮层和基底神经节中，以及（iii）感觉运动处理的改变。
文献回顾。
流行病学数据表明，那些演奏需要最大精细运动技能的乐器的音乐家风险更高。对于那些双手工作量不同的乐器，局灶性痉挛更常出现在使用更频繁的手上。在心理学研究中，患有手痉挛的音乐家比健康音乐家有更多的完美主义倾向。这些发现进一步证实了行为因素可能与音乐家手痉挛的病因有关。遗传因素可能比以前假设的更为重要。
我们提出了一个启发式模型，可以解释为什么音乐家中局灶性痉挛的发病率相对较高。该模型假设主要由遗传决定的易感性与内在和外在触发因素的共同作用。
