Ioannou Christos I, Furuya Shinichi, Altenmüller Eckart
Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Emmichplatz 1, 30175 Hanover, Germany.
Department of Information and Communication Science, Sophia University, 4-4 Chiyodaku, Tokyo, Japan.
Neuropsychologia. 2016 May;85:226-36. doi: 10.1016/j.neuropsychologia.2016.03.029. Epub 2016 Mar 29.
Recent investigations have suggested that stress can modulate motor function. However, the impact of stress on motor performance of musicians suffering from focal dystonia (FDM) remains unknown. The current study assessed motor performance in 20 FDM patients and 16 healthy musicians (HM) before and under stress. Stress was manipulated using the Trier Social Stress Test (TSST). Motor performance was evaluated based on analysis of electromyographic (EMG) activity and temporal variability, while electrocardiography (ECG) and the level of free cortisol were used to test for objective alterations of the hypothalamic-pituitary-adrenal (HPA) axis. Finally, the psychological profiles of both groups were analyzed using three psycho-diagnostic standardized questionnaires. Results showed that patients' motor impairments did not change under acute stressful conditions. However, an increase in muscular co-contractions was observed, reflecting a physiological muscular response under stressful conditions. Psycho-diagnostic analysis revealed higher levels of psychological traits related to elevated anxiety, stress and perfectionism in 40% of the patients. Although the motor outcome between those patients and those with an opposing psychological profile did not differ, patients characterized by stressful and perfectionistic personalities had, on average, developed dystonia about ten years earlier than the rest of the patients. The current study suggests that acute stress conditions may not have any direct impact on fine motor control of FDM patients. However psychological traits associated with increased stress, anxiety and perfectionism may have a long-lasting effect on the motor function of affected musicians, by promoting the acceleration or even the triggering of dystonia.
近期研究表明，压力可调节运动功能。然而，压力对患有局灶性肌张力障碍（FDM）的音乐家运动表现的影响仍不清楚。本研究评估了20名FDM患者和16名健康音乐家（HM）在应激前和应激状态下的运动表现。采用特里尔社会应激测试（TSST）来施加压力。基于肌电图（EMG）活动分析和时间变异性来评估运动表现，同时使用心电图（ECG）和游离皮质醇水平来检测下丘脑-垂体-肾上腺（HPA）轴的客观变化。最后，使用三份心理诊断标准化问卷对两组的心理特征进行分析。结果显示，在急性应激条件下患者的运动障碍没有改变。然而，观察到肌肉共同收缩增加，这反映了应激条件下的生理肌肉反应。心理诊断分析显示，40%的患者与焦虑、压力和完美主义相关的心理特征水平较高。尽管这些患者与具有相反心理特征的患者之间的运动结果没有差异，但具有应激和完美主义人格特征的患者平均比其他患者早约十年出现肌张力障碍。本研究表明，急性应激条件可能对FDM患者的精细运动控制没有任何直接影响。然而，与压力、焦虑和完美主义增加相关的心理特征可能通过促进肌张力障碍的加速甚至引发，对受影响音乐家的运动功能产生长期影响。
