Sensorimotor skills and focal dystonia are linked to putaminal grey-matter volume in pianists

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 82; no. 11; pp. 1225 - 1231
• Main Authors: Granert, Oliver, Peller, Martin, Jabusch, Hans-Christian, Altenmüller, Eckart, Siebner, Hartwig Roman
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.11.2011; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adult; Aged; Biological and medical sciences; brain mapping; Brain Mapping - methods; Diseases of striated muscles. Neuromuscular diseases; dystonia; dystonic disorders; Dystonic Disorders - diagnosis; Female; focal dystonia; globus pallidus; Hand; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Magnetic Resonance Imaging - methods; Male; Medical sciences; Middle Aged; Motor Cortex - physiology; Motor Cortex - physiopathology; Motor Skills - physiology; movement disorders; MRI; Music; Nervous system (semeiology, syndromes); Neurology; Piano; Psychomotor Performance - physiology; Putamen; Putamen - physiology; Schizophrenia; Studies; Vascular diseases and vascular malformations of the nervous system; Striated muscle disease; Nervous system diseases; Grey matter; Central nervous system disease; Dystonia; Neurological disorder; Involuntary movement; Cerebral disorder; Extrapyramidal syndrome
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.2011.245811

BackgroundFocal hand dystonia has been associated with morphometric changes and distorted somatotopic representations in the putamen.ObjectiveThe authors used voxel-based morphometry (VBM) to identify regions in the putamen where grey-matter volume is associated with musician's dystonia (MD) or the skill level of piano playing in professional pianists.MethodsIn 11 pianists with MD affecting the right hand and 12 healthy pianists without dystonia, the authors performed high-resolution T1-weighted MRI of the brain. The authors also measured the temporal variability of key strokes during scale playing with the right hand to characterise the individual skill level of piano playing. Statistical comparisons of the normalised and smoothed grey-matter maps were performed to test for dystonia and performance-related structural changes in the putamen.ResultsDuring scale playing, the timing of consecutive key strokes was more variable in MD patients than in non-dystonic pianists. Regional grey-matter volume in the middle part of left and right putamen increased with timing variability during piano playing in pianists with and without MD. Between-group comparisons revealed that MD patients had a larger grey-matter volume in the right middle putamen compared with healthy musicians.ConclusionIn highly trained pianists with and without MD, the volume of the associative motor territory in the middle putamen reflects both the skill level of piano playing and the presence of dystonia. While a smaller volume is associated with better timing skills, a relative expansion is correlated with the presence of focal task-specific hand dystonia.