Focal dystonia in Musicians

Musician's dystonia is a task-specific dystonia, i.e. a deterioration in fine motor control that usually affects only the instrument. Depending on the instrument, the fingers, the muscles of the mouth or, in singers, the vocal cords may contract involuntarily during playing, affecting the performance.

Musicians' dystonia occurs regardless of the situation and always in the same way - not only on stage or in tense situations, but also when practicing at home.

How and why musician's dystonia develops is not yet fully understood. However, we know from epidemiological studies, many of which were carried out at our institute, that various risk factors are involved in the development of music dystonia. These include very repetitive and temporally and spatially limited fine motor movements that are performed over a long period of time, but genetic factors, a late start to playing instruments, injuries and psychological factors also appear to play a role. It is important to know that - apart from extremely rare exceptions - it is not a purely psychologically caused or psychogenic disease, but a neurological disease in which there is a malfunction of the highly practiced fine motor processes, which is also reflected in structural and functional changes to the networks in the brain.

According to current knowledge, there is (still) no “cure” for music dystonia, i.e. no causal therapy. However, there are ways of treating the symptoms, which we also offer as part of our musician's consultation. These include the use of medication in tablet form, the injection of botolinum toxin into the muscles affected by the dystonia under high-resolution ultrasound control, as well as so-called “retraining”, in which movement patterns are slowly relearned over a longer process. In many cases, these methods - also in combination - can achieve such good results that even professional demands on the instrument can be met again.

Nevertheless, a deeper understanding of the underlying mechanisms is urgently needed in order to enable targeted prevention work and perhaps even better treatment options for those affected. As a world-renowned center for this disease, we are therefore conducting ongoing studies at our institute to contribute to a better understanding of how the disease develops.

To do this, we are always dependent on the help and support of those affected, but also of healthy musicians!

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