What´s behind Musician´s Dystonia?

Listener Relevance: Duchenne Muscular Dystrophy (DMD), is more common than people think and chances are sooner or later you will know of or see somebody affected by this disease.

Usually once atrophy of the hip musculature is noticed, shoulder weakness in noticed also. Those inflicted with DMD will also have trouble with overhead activates, and keeping the shoulders flexed for long periods of time. Scott M. Giles actually lists the following muscles affected by DMD: “Shoulder girdle musculature, pectorals, deltoids, rectus abdominals, gluteals, hamstrings, and calf muscles” 6. DMD patients continue to lose control and strength in their lower extremity musculature and eventually have so much trouble walking they are confined to a wheelchair. There is not a set age where this occurs, but the average is around twelve years old. The DMD muscles involved in eating, drinking, and of the eye are not touched by the disease. They usually do not have any hearing deficits or stroke disorders 1.

Parkinson disease (PD), also referred to as Parkinson’s disease and paralysis agitans, is a progressive neurodegenerative disease that is the third most common neurologic disorder of older adults. It is a debilitating disease affecting motor ability and is characterized by four cardinal symptoms: tremor rigidity, bradykinesia or kinesis (slow movement/no movement), and postural instability. Most people have primary, or idiopathic, disease. A few patients have secondary parkinsonian symptoms from conditions such as brain tumors and certain anti-psychotic drugs.

Parkinson's disease is a progressive neurological disorder that slowly erodes an individual's ability to care for themselves. Parkinson's does not have a standard set of symptoms and each person's experience with Parkinson's is unique. What is common is that the disease affects the body's ability to control muscle movements. This may result in tremors, muscle rigidity, difficulty walking, and an inability to perform any task requiring fine motor skills. There is no known cure for Parkinson's disease, and its progressive nature ensures that it is highly debilitating.

The symptoms begin in one part of the body, such as the face, neck, vocal cords, an arm or a leg and may spread to other parts of the body. They usually increase during stress, emotional upset or fatigue and decreases during rest and sleep. Dystonia can be inherited, caused by medication or some other underlying complication, but for the most part it is not known how it is contracted. An estimated 500,000 people in the United States have been diagnosed with Dystonia with an estimated 500,000 yet to be diagnosed or were misdiagnosed, making it the third most common movement disorder behind essential tremor and Parkinson’s disease. Dystonia is a mystery to many doctors and can take years to diagnose. Dr Mahlon DeLeon, medical director of the Dystonia Medical Research Foundation says, “Dystonia’s wide variety of forms has caused the disease to be misdiagnosed and there was a period of time when physicians thought this could have been in the mind. Now the medical community understands Dystonia’s symptoms are not all psychological and the recent discovery of new genes creates opportunities for advancements in treatment and eventually a

. Music has been included in many years for diseases such as Parkinson.to the use of music therapy patients with Parkinson's disease can regain some of their overall functioning. to the use of

In 1975 the first international conference on dystonia was held in New York. Eventually the separate disorders that can occur with Dystonia, being viewed separately, were viewed as being together. This led to a more up to date description of Dystonia in 1984. Dystonia is commonly missed diagnosed because of the many varying complications. In 2009 there was a push globally to describe and classify Dystonia since it is so hard to diagnose. Concerned committees met in 2011 and in 2012 where they decided that Dystonia needed further classification and clarification. Eventually it was agreed that a two-axis classification that separated phenomenology (axis I) from etiology (axis II) was needed. This allowed the cross referencing of symptoms and characteristics so that the disease can be properly diagnosed.

Muscular Dystrophy is a disorder that decreases the function of the body’s muscles and others that control vital organs. Muscular dystrophy means that the muscles lack nourishment causing them to lose their function and break down. All muscular dystrophy diseases have three things in common: they are all progressive, each have the same characteristics and cause weakness, and are hereditary. The word dystrophy originates from the Greek terms “dys,” meaning abnormal, and “trophe,” meaning nourishment(Westrum, Schade). Several of these diseases are very harmful to a person’s movement. It is caused by a mutation to a gene and is shown at birth or later in childhood.

Parkinson’s Disease is known as one of the most common progressive and chronic neurodegenerative disorders. It belongs to a group of conditions known as movement disorders. Parkinson disease is a component of hypokinetic disorder because it causes a decreased in bodily movement. It affects people who are usually over the age of 50. It can impair an individual motor as well as non-motor function. Some of the primary symptoms of Parkinson’s disease are characterized by tremors or trembling in hands, legs and arms. In early symptoms the tremor can be unilateral, appearing in one side of body but progression in the disease can cause it to spread to both sides; rigidity or a resistant to movement affects most people with Parkinson’s disease,

Tremor is the main symptom of PD but there are other simple symptoms like loss of balance, change in speech and slow movement. Many people and scientists in general believe that head damage or backbone damage as a result of accidents and other problems are the main cause of PD (Mayeux, 143). However, recent studies have indicated that psychiatric disorders are main cause of this PD. The main mental illness disorders that have been associated with PD are anxiety, affected disorders and schizophrenia. However, other issues such as trauma, depression and stress are risk factors for PD. Recent studies have provided different results on the relationship between psychiatric disorders and PD and the studied had many limitations especially due to bias and that is why this research was conducted to provide more reliable information on the relationship between psychiatric disorder and PD. However, the reliability of this research has not yet been guaranteed and that is why the study will be put under critique in this paper.

"We believe that music could potentially be used as an intervention to help people with epilepsy," said Christine Charyton, PhD, adjunct assistant professor and visiting assistant professor of neurology at The Ohio State University Wexner Medical Center, who presented the research at the American Psychological Association's 123rd Annual Convention.

This type of rehabilitation is especially helpful in improving balance, mobility, and endurance. Contact improvisation and tango are two types of dance that are often used for people with Parkinson’s (Marchant et al. 188-189). In a recent study conducted by the University of Limerick in Ireland, it was stated that the attendance rate was much higher than with regular therapy sessions and many of the patients requested that their programs be extended (Shanahan et al.). Dance might be a long-term solution to aid people with Parkinson’s. It not only helps to improve the body functions, but it works on the emotional level of the patient causing them to enjoy and become emotionally invested in these programs. In another study conducted by the American Dance Therapy Association, a dance class lasting two hours per week for twelve months had proven to better the gait, balance, upper extremity function and quality of life in the participants with Parkinson’s disease. This is in part because dance activates structures in the brain such as the parietal lobe, basal ganglia, and cerebellum that are specific only to dance, as well as, areas in the brain normally activated by motor tasks (Mandelbaum & Lo 173). The American Dance Therapy Association study stated “Dance is thought to involve multiple neural networks that involve motor learning, balance, and spatial integration, as well as

Focal dystonia in musicians is called musician’s dystonia or musician’s cramp. It is a task-specific movement disorder that causes coordination issues in muscles and a loss of motor control while a musician is playing their instrument. For musicians who become affected by focal dystonia, they discover that it is very disabling and in many cases the disorder can end their music careers (Schuele, 2004). Musician’s dystonia is painless and it affects as many as 1 in 200 musicians during their career and 1-14% of musicians seen in a performing arts medical center (Altenmüller, 2003). Altenmüller also reports that the numbers given may be underestimated due some musicians simply not reporting. In his opinion, he suggested that not reporting

Parkinson’s disease is a progressive disorder of the nervous system characterized by tremor, slowed movement, and muscle rigidity; typically only seen in those over the age of forty. It is named after James Parkinson, an English surgeon, whom first described the symptoms of “the shaking palsy,” in a report published in 1817 (Grimes, 2004).

Department of Health and Human Services, in some patients, tremor happens in conjunction with a neurological disorder, while in other patients it happens due to use of certain drugs. Nevertheless, the National Institute of Neurological Disorders and Stroke (2012), notes “The most common form of tremor, however, occurs in otherwise largely healthy people” (para. 1). Although most tremors neither cause severe health problems nor threaten life, most patients experience many difficulties in performing daily activities. It is very embarrassing to many people, especially older individuals. Tremor may lessen quality of life, and reduce ability to perform daily life tasks such as eating, drinking, writing, and changing clothing. Some patients with mild tremor do not visit doctors if tremor does not hinder their daily life activities. Their situations often worsen over time. Tremors can rarely affect children, and there is no data on the popularity of the disease in childhood (Harvard Medical School,