Brain curse strikes musicians

By Pat Hagan

Musicians' brains may be over trained

Hearing a skilled musician play a piece note-perfect is one of the joys of life. But do some professional musicians pay a terrible price for their talent?

A team of British researchers has recently embarked on a study that they hope will shed light on a mysterious condition that can affect the brains of up to one in ten musical artists.

Aided by a grant of over £92,000 from the charity Action Medical Research, experts from the Institute of Neurology and the National Hospital for Neurology and Neurosurgery in London hope to come up with a treatment for a condition called occupational dystonia - which leaves many experienced players with involuntary muscle spasms of the hand.

The disorder can affect people in many occupations that involve high levels of skill in performing certain types of movement.

But it appears to be particularly striking in musicians and for some, the consequences for their performing career can be catastrophic.

Too specialised

There are millions of connections in the brain and these are forever changing from moment to moment to optimise the way you do things Dr Karin Rosenkranz

Experts believe the root cause of occupational dystonia is that the brain somehow becomes "overspecialised" in carrying out very specific movements.

In short, part of the brain becomes permanently "rewired" so that it is highly adept at the skills it has been using for years but unable to learn new, more flexible movements.

Musicians have been chosen for the study because many cultivate their playing talent from an early age - when the brain is most susceptible to change.

This can result is structural changes to the brain that can even be identified on a scan.

Although the hand is often affected, even wind instrument players can suffer loss of muscle control around their mouths that can dramatically affect their playing.

Dr Karin Rosenkranz, one of the researchers involved, believes the symptoms of dystonia may be the price some musicians pay for becoming so specialised in their instrument.

"There are millions of connections in the brain and these are forever changing from moment to moment to optimise the way you do things.

"This 'rewiring' can become more permanent if you keep doing things over and over again, like, for example, practising the piano.

"One pay-off for this specialisation is that the 'overtrained' brain may not be flexible when it has to adjust to other things.

"Perhaps in an overspecialised system, the normal processes that adapt to new tasks can go awry and lead to permanent changes, rather than the temporary ones that are needed."

Questions remain

But Dr Rosenkranz admits researchers are puzzled as to why dystonia does not affect all musicians, instead of the 5% to 10% who do develop it.

"It may be that they have some other subtle difference in their brains which causes it to go a little too far in its specialisation for one task."

Professor John Rothwell, a specialist in human neurophysiology at the Institute of Neurology, is also taking part in the study and hopes a new and inexpensive treatment that gets the brain to rewire itself will stop the spasms from occurring.

The treatment involves prodding individual muscles with a hand-held probe that vibrates very gently.

"We think that in musicians this training has gone too far in one direction," he said.

"The brain has less adaptability and we are trying to retrain it back a bit by making it concentrate on something other than just practising the violin or piano."

Improvements

The technique, which has already been tried out on healthy subjects, involves placing the vibrating tool on the hand for about 15 minutes.

It is vital that the musician concentrates on the sensation as this helps the brain rewire itself.

Experiments show an improvement for up to an hour after the treatment.

It is hoped that after several sessions of therapy, these changes will become permanent.

"We imagine that we are reinforcing these brain connections that have not been used for a long time," said Professor Rothwell.

"But the patient has to concentrate because this is a form of learning."

In the long term, it is hoped the treatment will also benefit other conditions where muscle spasms can cause problems, such as brain injury and stroke.

However, the researchers believe music teachers could do more to prevent the condition by allowing students to take regular breaks during practice.