Affiliations: Institute of Music Physiology and Musicians' Medicine, University of Music, Drama and Media, Hanover, Germany | Institute of Musicians' Medicine, University of Music Carl Maria von Weber, Dresden, Germany | Department of Clinical Neurophysiology, Georg-August University, Goettingen, Germany | Psychiatric University Hospital, and Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
Note: [] Corresponding author: Prof. Dr. med. Eckart Altenmüller, MD, MA, PhD, Director of the Institute of Music Physiology and Musicians' Medicine (IMMM), University of Music, Drama and Media Hanover, Emmichplatz 1, D-30175 Hannover, Germany. Tel.: +49 0 511 3100 552; Fax: +49 0 511 3100 557; Web: www.immm.hmt-hannover.de. Email: altenmueller@hmt-hannover.de
Abstract: Background: Focal dystonia in musicians (MD) is a task-specific movement disorder with a loss of voluntary motor control during instrumental playing. Defective inhibition on different levels of the central nervous system is involved in the pathophysiology. Sensorimotor retraining is a therapeutic approach to MD and aims to establish non-dystonic movements. Transcranial direct current stimulation (tDCS) modulates cortical excitability and alters motor performance. In this study, tDCS of the motor cortex was expected to assist retraining at the instrument. Methods: Nine professional pianists suffering from MD were included in a placebo-controlled double-blinded study. Retraining consisted of slow, voluntarily controlled movements on the piano and was combined with tDCS. Patients were treated with three stimulation protocols: anodal tDCS, cathodal tDCS and placebo stimulation. Results: No beneficial effects of single-session tDCS-supported sensorimotor retraining on fine motor control in pianists with MD were found in all three conditions. Conclusions: The main cause of the negative result of this study may be the short intervention time. One retraining session with a duration of 20 min seems not sufficient to improve symptoms of MD. Additionally, a single tDCS session might not be sufficient to modify sensorimotor learning of a highly skilled task in musicians with dystonia.
Keywords: Focal dystonia, motor control, neuronal plasticity, transcranial direct current stimulation, retraining
