Treating the musician rather than the symptom: the holistic tools employed by current practices to attend to the non-motor problems of musicians with task-specific focal dystonia

Musicians Focal Dystonia (MFD) is a task-specific movement disorder affecting highly skilled musicians. The pathophysiology is poorly understood, and the available treatments are unable to fully and reliably rehabilitate the affected skill. Recently, the exclusively neurological nature of the condition has been questioned, and additional psychological, behavioral, and psychosocial contributing factors were identified. However, very little is known about how these factors influence the recovery process, and how, if at all, they are addressed in ongoing practices. For this study, 14 practitioners with substantial experience in working with musicians with MFD were interviewed about the elements in their approach which are directed at the cognition, emotions, attitudes, and behaviors of their patients and clients. A wide variety of tools were reported in three areas: (1) creating a supportive learning environment and addressing anxiety and perfectionism, (2) using body-oriented methods to optimize the playing behaviors and (3) consciously channeling the focus of attention to guide the physical retraining exercises and establishing new habits. The study also revealed that in-depth knowledge of the instrumental technique is profitable to retrain the impaired motor patterns. Therefore, the importance of including music educators in developing new therapeutic approaches will also be highlighted

Sleep loss and recovery after administration of drugs related to different arousal systems in rats

Sleep is homeostatically regulated suggesting a restorative function. Sleep deprivation is compensated by an increase in length and intensity of sleep. In this study, suppression of sleep was induced pharmacologically by drugs related to different arousal systems. All drugs caused non-rapid eye movement (NREM) sleep loss followed by different compensatory processes. Apomorphine caused a strong suppression of sleep followed by an intense recovery. In the case of fluoxetine and eserine, recovery of NREM sleep was completed by the end of the light phase due to the biphasic pattern demonstrated for these drugs first in the present experiments. Yohimbine caused a long-lasting suppression of NREM sleep, indicating that either the noradrenergic system has the utmost strength among the examined systems, or that restorative functions occurring normally during NREM sleep were not blocked. Arousal systems are involved in the regulation of various wakefulness-related functions, such as locomotion and food intake. Therefore, it can be hypothesized that activation of the different systems results in qualitatively different waking states which might affect subsequent sleep differently. These differences might give some insight into the homeostatic function of sleep in which the dopaminergic and noradrenergic systems may play a more important role than previously suggested

Exploring the impact of the somatic method ‘Timani’ on performance quality, performance-related pain and injury, and self-efficacy in music students in Norway: an intervention study

The importance of including performance-related body mechanics into music education to improve performance quality and prevent performance-related injuries has been stressed by many researchers recently. However, it is unclear how this information could be delivered most effectively. The somatic method ‘Timani’ provides a practical solution by combining expertise in music performance and functional body mechanics with the goal of achieving a more efficient playing technique. Since no in-depth study has been conducted to assess the method before, we explored the impact of this method on young musicians’ performance through an online, 4-week-long Timani intervention with a mixed-methodology design. 17 students (mean age = 19.17 years) were recruited from the Norwegian Academy of Music. They participated in two group workshops at the beginning and the end of the project and received four individual Timani sessions administered by certified teachers. We collected survey data at the workshops about performance-related pain and self-efficacy, and qualitative feedback after each session. In addition, all sessions were observed by the researcher and semi-structured interviews were conducted with the teachers about the perceived outcomes and their experiences with teaching the method online. Our findings show that the intervention had a positive impact on a physical, professional, and to some extent, psychological and behavioral level. The improvements included better posture when playing, enhanced control and dexterity in the upper extremities, and improved breathing mechanisms. The seven students who had performance-related pain pre-intervention reported a reduction in the discomfort. The positive results were achieved by the dual expertise of the teachers in music performance and functional body mechanics, the structure of the sessions, the communication, and the pedagogical tools used. Both students and teachers felt that administering the sessions online was satisfactory and produced good results. Timani is a promising method to establish healthy playing and singing habits thus improving performance quality and preventing performance-related problems and has great potential in reducing pre-existing injuries and pain. Also, it can be effectively taught online which has further implications for the logistics of delivery

Cyclic and Sleep-Like Spontaneous Alternations of Brain State Under Urethane Anaesthesia

Background: Although the induction of behavioural unconsciousness during sleep and general anaesthesia has been shown to involve overlapping brain mechanisms, sleep involves cyclic fluctuations between different brain states known as active (paradoxical or rapid eye movement: REM) and quiet (slow-wave or non-REM: nREM) stages whereas commonly used general anaesthetics induce a unitary slow-wave brain state. Methodology/Principal Findings: Long-duration, multi-site forebrain field recordings were performed in urethaneanaesthetized rats. A spontaneous and rhythmic alternation of brain state between activated and deactivated electroencephalographic (EEG) patterns was observed. Individual states and their transitions resembled the REM/nREM cycle of natural sleep in their EEG components, evolution, and time frame (,11 minute period). Other physiological variables such as muscular tone, respiration rate, and cardiac frequency also covaried with forebrain state in a manner identical to sleep. The brain mechanisms of state alternations under urethane also closely overlapped those of natural sleep in their sensitivity to cholinergic pharmacological agents and dependence upon activity in the basal forebrain nuclei that are the major source of forebrain acetylcholine. Lastly, stimulation of brainstem regions thought to pace state alternations in sleep transiently disrupted state alternations under urethane. Conclusions/Significance: Our results suggest that urethane promotes a condition of behavioural unconsciousness tha

Musicians focal dystonia: the practitioner’s perspective on psychological, psychosocial, and behavioural risk factors and non-motor symptoms

Musician’s focal dystonia (MFD) is a painless, task-specific neurological movement disorder that impairs fine motor control when playing an instrument. The pathophysiology is not fully understood, and while the available treatment strategies can help with improving motor control, they are rarely able to fully and reliably rehabilitate playing skills. Recent studies suggest that apart from genetic factors, maladaptive neuroplasticity, and the repetitive nature of the instrumental technique, psychosocial, psychological, and behavioural factors might also play a role in the onset of MFD. However, the presence of some of these risk factors is supported primarily by anecdotal evidence, with only a few aspects examined empirically. To explore this area further, 14 semi-structured interviews were conducted with a convenience sample of practitioners (8 medical professionals and 6 musician-coaches) who frequently treated MFD sufferers. Throughout their career, these participants are estimated to have interacted with more than 2,000 musicians with MFD, creating a large, indirect sample. A detailed patient profile emerged from the data with three main components: 1) the negative impact of social environments, including traumatic experiences and low quality of instrumental teaching; 2) a perfectionist, anxious, overly sensitive, and acquiescent personality type; and 3) obsessive, controlling, and inadequate practice behaviours. Participants stated MFD needs to be treated holistically and that neglecting these aspects during treatment could jeopardise rehabilitation. Further objective, controlled research trials are needed to describe these factors in detail, quantify their potential impact as risk factors, and understand how they might hinder therapy

Musician’s focal dystonia: a mere neurological disorder? The role of non-organic factors in the onset of musician’s focal dystonia: an exploratory Grounded Theory study

Musician’s Focal Dystonia (MFD) is a task-specific, neurological disorder with poorly understood pathophysiology, affecting highly skilled musicians, ending successful careers. Studies found neurological changes in the sufferers’ brains, which presumably occurred via negative neuroplasticity, however, surprisingly little is known of what triggers these changes. Recently, non-organic risk factors, such as maladaptive psychological traits and preceding trauma have been suggested by a handful of studies, but the field has not yet been explored in detail. The aim of the study was to identify and describe the non-organic factors which might contribute to the onset of MFD. Due to the study’s exploratory nature, a qualitative constructivist Grounded Theory (GT) design was chosen, with the goal of generating a theory that emerges directly from the data. 15 MFD sufferers (5 females, mean age = 36.1) were interviewed for the study. Apart from previously suggested traits, such as anxiety and perfectionism, we found that the educational environment might also be influential. Many participants studied in a negative emotional climate, faced unattainable demands, and were instructed to focus only on the technical aspects of their playing. Consequently, they developed unhealthy practice strategies and negative perfectionism and these problems were often accompanied by negative emotional coping and maladaptive health behaviours. In addition, many participants experienced trauma before the onset of the condition. These findings support the theory that MFD is a multifaceted condition that could partially originate from non-organic factors. It also suggests that the environment – especially the educational approach – might be more influential than previously thought. This might have further implications not only for prevention and research but for the treatment strategies as well. It is likely, that opposing a purely medical procedure, an interdisciplinary approach would enhance the currently used therapies and would increase the possibility of the rehabilitation of the suffering musicians. ******* NOTE: this article is available open access at the link below ******