Help for Musicians

By Brenda Arthur

Loss of muscle control or dystonia is disconcerting to anyone, but it can be a career-ending disorder for trained musicians.

Characterized by excessive muscle contractions, musician’s dystonia disrupts the fine motor control musicians need to perform. Treating patients with this disorder is one part of the Music and Movement Disorders Initiative created by Christine Kim, MD, assistant professor of neurology in the Division of Movement Disorders.

“Professional musicians have a singular identity,” says Dr. Kim. “They start training early and decide on a career path at a relatively young age. It requires many hours of practice and achieving that high level is rewarding, but when disrupted, it’s devastating.”

Musicians with dystonia can be in their 20s and 30s. “The majority have to leave music performance because they are unable to play with the precision required of a professional,” says Dr. Kim, who trained as a professional violinist.

Dystonia comes from aberrant brain activity that likely develops, in part, from over-training in repetitive motions. Violinists more commonly develop dystonia in the fingers of the left hand, which do more repetitive work through the years. Those who perform with brass and wind instruments sometimes develop involuntary, distorted movements of their mouths.

The primary treatment is the injection of botulinum toxin into the affected muscles, which reduces the frequency of contractions but may also weaken the muscles.

Dr. Kim wants to understand what happens in the brain with musician’s dystonia so she can develop better therapies. A functional MRI study that is underway will help Dr. Kim characterize central brain changes.

“We are looking to immediately improve clinical care through translational research,” she says. “By identifying and researching gaps in current treatments, we can return with new approaches that directly improve patients’ lives.”

Dr. Kim also uses music as medicine for people with other movement disorders, including Parkinson’s, atypical parkinsonism, tremor, ataxia, chorea, and other types of dystonia. “Patients tell us they move better when they listen to music while walking, for example. They recover their fluidity better.”

Dr. Kim credits much of the music program’s success to local collaborators: the interactive concert series through Project: Music Heals Us, a nonprofit that provides education, engagement, and healing through virtual and live musical performances and interactive programming, and the Manhattan School of Music Community Partnership that takes music to students, seniors, and hospice patients.

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