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Uehara K, Yasuhara M, Koguchi J, Oku T, Shiotani S, Morise M, Furuya S. Brain network flexibility as a predictor of skilled musical performance. Cereb Cortex 2023; 33:10492-10503. [PMID: 37566918 DOI: 10.1093/cercor/bhad298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Interactions between the body and the environment are dynamically modulated by upcoming sensory information and motor execution. To adapt to this behavioral state-shift, brain activity must also be flexible and possess a large repertoire of brain networks so as to switch them flexibly. Recently, flexible internal brain communications, i.e. brain network flexibility, have come to be recognized as playing a vital role in integrating various sensorimotor information. Therefore, brain network flexibility is one of the key factors that define sensorimotor skill. However, little is known about how flexible communications within the brain characterize the interindividual variation of sensorimotor skill and trial-by-trial variability within individuals. To address this, we recruited skilled musical performers and used a novel approach that combined multichannel-scalp electroencephalography, behavioral measurements of musical performance, and mathematical approaches to extract brain network flexibility. We found that brain network flexibility immediately before initiating the musical performance predicted interindividual differences in the precision of tone timbre when required for feedback control, but not for feedforward control. Furthermore, brain network flexibility in broad cortical regions predicted skilled musical performance. Our results provide novel evidence that brain network flexibility plays an important role in building skilled sensorimotor performance.
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Affiliation(s)
- Kazumasa Uehara
- Neural Information Dynamics Laboratory, Department of Computer Science and Engineering, Toyohashi University of Technology, Toyohashi, Japan
- Sony Computer Science Laboratories Inc, Tokyo 1410022, Japan
| | - Masaki Yasuhara
- Sony Computer Science Laboratories Inc, Tokyo 1410022, Japan
- Neural Engineering Laboratory, Department of Science of Technology Innovation, Nagaoka University of Technology, Nagaoka, Japan
| | - Junya Koguchi
- Sony Computer Science Laboratories Inc, Tokyo 1410022, Japan
- Graduate School of Advanced Mathematical Sciences, Meiji University, Tokyo, Japan
| | | | | | - Masanori Morise
- Sony Computer Science Laboratories Inc, Tokyo 1410022, Japan
- School of Interdisciplinary Mathematical Sciences, Meiji University, Tokyo, Japan
| | - Shinichi Furuya
- Sony Computer Science Laboratories Inc, Tokyo 1410022, Japan
- NeuroPiano Institute, Kyoto 6008086, Japan
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Mantel T, Lee A, Furuya S, Morise M, Altenmüller E, Haslinger B. Reliability and Validity of the Embouchure Dystonia Severity Rating Scale. J Mov Disord 2023; 16:191-195. [PMID: 37258280 DOI: 10.14802/jmd.22213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/05/2023] [Indexed: 06/02/2023] Open
Abstract
OBJECTIVE Embouchure dystonia (ED) is a task-specific movement disorder that leads to loss of fine motor control of the embouchure and tongue muscles in wind musicians. In contrast to musicians' hand dystonia, no validated severity rating for ED exists, posing a major obstacle for structured assessment in scientific and clinical settings. The aim of this study is to validate an ED severity rating scale (EDSRS) allowing for a standardized estimation of symptom severity in ED. METHODS The EDSRS was set up as a composite score of six items evaluating audio-visual disease symptoms during the performance of three standardized musical tasks (sustained notes, scales, and fourths) separately for each body side. For validation, 17 musicians with ED underwent standardized audiovisual recordings during performance. Anonymized and randomized recordings were assessed by two experts in ED (raters). Statistical analysis included metrics of consistency, reliability, and construct validity with the fluctuation of the fundamental frequency of the acoustic signal (F0) (extracted in an audio analysis of the sustained notes). RESULTS The EDSRS showed high internal consistency (Cronbach's α = 0.975-0.983, corrected item-total correlations r = 0.90-0.96), interrater reliability (intraclass correlation coefficient [ICC] for agreement/consistency = 0.94/0.96), intrarater reliability over time (ICC per rater = 0.93/0.87) and good precision (standard error of measurement = 2.19/2.65), and correlated significantly with F0 variability (r = 0.55-0.60, p = 0.011-0.023). CONCLUSION The developed EDSRS is a valid and reliable tool for the assessment of ED severity in the hands of trained expert raters. Its easy applicability makes it suitable not only for routine clinical practice but also for scientific studies.
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Affiliation(s)
- Tobias Mantel
- Department of Neurology, Technical University of Munich, Munich, Germany
| | - André Lee
- Department of Neurology, Technical University of Munich, Munich, Germany
- Institute for Music Physiology and Musicians' Medicine, Hannover University of Music, Drama, and Media, Hanover, Germany
| | - Shinichi Furuya
- Institute for Music Physiology and Musicians' Medicine, Hannover University of Music, Drama, and Media, Hanover, Germany
- Sony Computer Science Laboratories Inc. (Sony CSL), Tokyo, Japan
- NeuroPiano Institute, Kyoto, Japan
| | - Masanori Morise
- Meiji University, School of Interdisciplinary Mathematical Sciences, Tokyo, Japan
| | - Eckart Altenmüller
- Institute for Music Physiology and Musicians' Medicine, Hannover University of Music, Drama, and Media, Hanover, Germany
| | - Bernhard Haslinger
- Department of Neurology, Technical University of Munich, Munich, Germany
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Kuster JK, Levenstein JM, Waugh J, Multhaupt-Buell TJ, Lee MJ, Kim BW, Pagnacco G, Makhlouf ML, Sudarsky LR, Breiter HC, Sharma N, Blood AJ. Sustained activation in basal ganglia and cerebellum after repetitive movement in a non-task-specific dystonia. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.19.533030. [PMID: 36993354 PMCID: PMC10055227 DOI: 10.1101/2023.03.19.533030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
We previously observed sustained fMRI BOLD signal in the basal ganglia in focal hand dystonia patients after a repetitive finger tapping task. Since this was observed in a task-specific dystonia, for which excessive task repetition may play a role in pathogenesis, in the current study we asked if this effect would be observed in a focal dystonia (cervical dystonia [CD]) that is not considered task-specific or thought to result from overuse. We evaluated fMRI BOLD signal time courses before, during, and after the finger tapping task in CD patients. We observed patient/control differences in post-tapping BOLD signal in left putamen and left cerebellum during the non-dominant (left) hand tapping condition, reflecting abnormally sustained BOLD signal in CD. BOLD signals in left putamen and cerebellum were also abnormally elevated in CD during tapping itself and escalated as tapping was repeated. There were no cerebellar differences in the previously studied FHD cohort, either during or after tapping. We conclude that some elements of pathogenesis and/or pathophysiology associated with motor task execution/repetition may not be limited to task-specific dystonias, but there may be regional differences in these effects across dystonias, associated with different types of motor control programs.
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Doll-Lee J, Lee A, Mantel T, Haslinger B, Altenmüller E. Embouchure Dystonia as a Network Disease. ADVANCES IN NEUROBIOLOGY 2023; 31:45-59. [PMID: 37338695 DOI: 10.1007/978-3-031-26220-3_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
While the pathophysiology of embouchure dystonia, a sub-entity of musician's dystonia, is still not fully understood, recent research has shown that it involves alterations of several brain functions and networks. Maladaptive plasticity in sensorimotor integration, sensory perception, and deficient inhibitory mechanisms at cortical, subcortical, and spinal level seem to contribute to its pathophysiology. Furthermore, functional systems of the basal ganglia and the cerebellum are involved, clearly pointing toward a network disorder. We therefore propose a novel network model, based on electrophysiological and recent neuroimaging studies highlighting embouchure dystonia.
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Affiliation(s)
- Johanna Doll-Lee
- Department of Neurology, Hannover Medical School, Hannover, Germany.
| | - André Lee
- Institute of Music Physiology and Musician's Medicine, Hannover University of Music, Drama and Media, Hannover, Germany.
- Department of Neurology, Klinikum rechts der Isar Technische Universität München, Munich, Germany.
| | - Tobias Mantel
- Department of Neurology, Klinikum rechts der Isar Technische Universität München, Munich, Germany
| | - Bernhard Haslinger
- Department of Neurology, Klinikum rechts der Isar Technische Universität München, Munich, Germany
| | - Eckart Altenmüller
- Institute of Music Physiology and Musician's Medicine, Hannover University of Music, Drama and Media, Hannover, Germany
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5
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Lustenhouwer R, Cameron IG, van Alfen N, Toni I, Geurts AC, van Engelen BG, Groothuis JT, Helmich RC. Cerebral Adaptation Associated with Peripheral Nerve Recovery in Neuralgic Amyotrophy: A Randomized Controlled Trial. Neurorehabil Neural Repair 2023; 37:3-15. [PMID: 36575812 PMCID: PMC9896536 DOI: 10.1177/15459683221145149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Neuralgic amyotrophy (NA) is a common peripheral nerve disorder caused by auto-immune inflammation of nerves in the brachial plexus territory, characterized by acute pain and weakness of the shoulder muscles, followed by motor impairment. Recent work has confirmed that NA patients with residual motor dysfunction have abnormal cerebral sensorimotor representations of their affected upper extremity. OBJECTIVE To determine whether abnormal cerebral sensorimotor representations associated with NA can be altered by specialized, multidisciplinary outpatient rehabilitation focused on relearning motor control. METHODS 27 NA patients with residual lateralized symptoms in the right upper extremity participated in a randomized controlled trial, comparing 17 weeks of multidisciplinary rehabilitation (n = 16) to usual care (n = 11). We used task-based functional MRI and a hand laterality judgment task, which involves motor imagery and is sensitive to altered cerebral sensorimotor representations of the upper extremity. RESULTS Change in task performance and related brain activity did not differ significantly between the multidisciplinary rehabilitation and usual care groups, whereas the multidisciplinary rehabilitation group showed significantly greater clinical improvement on the Shoulder Rating Questionnaire. Both groups, however, showed a significant improvement in task performance from baseline to follow-up, and significantly increased activity in visuomotor occipito-parietal brain areas, both specific to their affected upper extremity. CONCLUSIONS Abnormal cerebral sensorimotor representations of the upper extremity after peripheral nerve damage in NA can recover toward normality. As adaptations occurred in visuomotor brain areas, multidisciplinary rehabilitation after peripheral nerve damage may be further optimized by applying visuomotor strategies. This study is registered at ClinicalTrials.gov (NCT03441347).
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Affiliation(s)
- Renee Lustenhouwer
- Department of Rehabilitation, Radboud
university medical center, Donders Institute for Brain, Cognition and Behaviour,
Nijmegen, the Netherlands,Donders Centre for Cognitive
Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud
University, Nijmegen, the Netherlands
| | - Ian G.M. Cameron
- Donders Centre for Cognitive
Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud
University, Nijmegen, the Netherlands,Faculty of Electrical Engineering,
Mathematics and Computer Science, University of Twente, Enschede, The
Netherlands
| | - Nens van Alfen
- Department of Neurology, Radboud
university medical center, Donders Institute for Brain, Cognition and Behaviour,
Nijmegen, the Netherlands
| | - Ivan Toni
- Donders Centre for Cognitive
Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud
University, Nijmegen, the Netherlands
| | - Alexander C.H. Geurts
- Department of Rehabilitation, Radboud
university medical center, Donders Institute for Brain, Cognition and Behaviour,
Nijmegen, the Netherlands
| | - Baziel G.M. van Engelen
- Department of Neurology, Radboud
university medical center, Donders Institute for Brain, Cognition and Behaviour,
Nijmegen, the Netherlands
| | - Jan T. Groothuis
- Department of Rehabilitation, Radboud
university medical center, Donders Institute for Brain, Cognition and Behaviour,
Nijmegen, the Netherlands,Jan T. Groothuis, Radboud university
medical center, Department of Rehabilitation, P.O. Box 9101, Nijmegen, 6500 HB,
The Netherlands.
| | - Rick C. Helmich
- Donders Centre for Cognitive
Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud
University, Nijmegen, the Netherlands,Department of Neurology, Radboud
university medical center, Donders Institute for Brain, Cognition and Behaviour,
Nijmegen, the Netherlands
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Takiyama K, Mugikura S, Furuya S. Impaired feedforward control of movements in pianists with focal dystonia. Front Neurol 2022; 13:983448. [PMID: 36034302 PMCID: PMC9413149 DOI: 10.3389/fneur.2022.983448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Learning accurate and fast movements typically accompanies the modulation of feedforward control. Nevertheless, it remains unclear how motor skill learning modulates feedforward control, such as through maladaptation of the sensorimotor system by extensive training (e.g., task-specific dystonia). Here, we examined the modulation of feedforward control through motor skill learning while focusing on the motion of piano playing at either a natural tempo or the fastest tempo. The current study compared the kinematics and keypress data among individuals in three groups: healthy and well-trained pianists (i.e., subjects with skill learning), non-musicians (i.e., subjects without skill learning), and patients with focal-hand dystonia (FHD) (i.e., subjects with maladaptation by skill learning). Compared to healthy pianists, patients with FHD showed impairment in some feedforward motion components that are relevant to classifying the two playing tempi. However, while focusing on motion components that are irrelevant to the tempo classification, patients with FHD showed movements comparable to those of healthy pianists. Furthermore, patients with FHD demonstrated significantly slower movement times than healthy pianists. Our results suggest that maladaptation by skill learning affects parts of feedforward control rather than its entirety. Nevertheless, the affected feedforward components are relevant to performing movements as fast as possible, which may underlie the speed dependence of dystonic symptoms.
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Affiliation(s)
- Ken Takiyama
- Department of Electrical Engineering and Computer Science, Tokyo University of Agriculture and Technology, Koganei, Japan
- *Correspondence: Ken Takiyama
| | - Shuta Mugikura
- Department of Electrical Engineering and Computer Science, Tokyo University of Agriculture and Technology, Koganei, Japan
| | - Shinichi Furuya
- Sony Computer Science Laboratories Inc. (Sony CSL), Tokyo, Japan
- Sophia University, Tokyo, Japan
- Institute for Music Physiology and Musicians' Medicine, Hannover University of Music, Drama, and Media, Hannover, Germany
- NeuroPiano Institute, Kyoto, Japan
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7
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Blood AJ. De-anthropomorphizing brain mapping: How a “component” perspective unbounded by behavioral categories may reconcile localization vs. circuit-based models of brain function. Front Syst Neurosci 2022; 16:946715. [PMID: 35965999 PMCID: PMC9363603 DOI: 10.3389/fnsys.2022.946715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/30/2022] [Indexed: 12/03/2022] Open
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8
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Yang J, Shao Y, Shen YK, Zhu HS, Li B, Yu QY, Kang M, Xu SH, Ying P, Ling Q, Zou J, Wei H, He YL. Altered Intrinsic Brain Activity in Patients With Toothache Using the Percent Amplitude of a Fluctuation Method: A Resting-State fMRI Study. Front Neurol 2022; 13:934501. [PMID: 35812119 PMCID: PMC9259968 DOI: 10.3389/fneur.2022.934501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
Objective The percent amplitude of fluctuation (PerAF) technique was utilized to evaluate the neural functions of specific cerebrum areas in patients with toothache (TA). Patients and Methods An aggregation of 18 patients with TA (eight males and 10 females) were included in the study. We also recruited 18 healthy controls (HCs; eight men and 10 women) aligned for sex and age. Resting functional magnetic resonance imaging (rs-fMRI) scans were obtained. Then, we utilized the PerAF method and a support vector machine (SVM) to analyze the image data and measure neural abnormalities in related cerebrum areas. Receiver operating characteristic (ROC) curve analysis was utilized to appraise the two data sets. Results The PerAF signals in the right dorsolateral superior frontal gyrus (RDSFG) and the right posterior central gyrus (RPCG) of TA sufferers were lower than HC signals. These results may reveal neural dysfunctions in relevant cerebrum regions. The AUC values of PerAF in the two areas were 0.979 in the RDSFG and 0.979 in the RPCG. The SVM results suggested that PerAF could be utilized to distinguish the TA group from HCs with a sensitivity of 75.00%, a specificity of 66.67%, and an accuracy of 70.83%. Conclusion Patients with TA had marked differences in PerAF values in some regions of the cerebrum. Changes in PerAF values represented distinctions in blood oxygen level dependent semaphore intensity, which reflected the overactivity or inactivation of some cerebrum areas in those suffering from TA. At the same time, we analyzed the PerAF values of TAs with ROC curve, which can be helpful for the diagnosis of TA severity and subsequent treatment. Our results may help to elucidate the pathological mechanism of TA.
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Affiliation(s)
- Jun Yang
- The Affiliated Stomatological Hospital of Nanchang University, The Key Laboratory of Oral Biomedicine, Nanchang, China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yan-Kun Shen
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hong-Shui Zhu
- The Affiliated Stomatological Hospital of Nanchang University, The Key Laboratory of Oral Biomedicine, Nanchang, China
| | - Bin Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qiu-Yue Yu
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Min Kang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - San-Hua Xu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ping Ying
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qian Ling
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jie Zou
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hong Wei
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yu-Lin He
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Yu-Lin He
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Zito GA, Tarrano C, Jegatheesan P, Ekmen A, Béranger B, Rebsamen M, Hubsch C, Sangla S, Bonnet C, Delorme C, Méneret A, Degos B, Bouquet F, Brissard MA, Vidailhet M, Gallea C, Roze E, Worbe Y. Somatotopy of cervical dystonia in motor-cerebellar networks: Evidence from resting state fMRI. Parkinsonism Relat Disord 2021; 94:30-36. [PMID: 34875561 DOI: 10.1016/j.parkreldis.2021.11.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Cervical dystonia is the most frequent form of isolated focal dystonia. It is often associated with a dysfunction in brain networks, mostly affecting the basal ganglia, the cerebellum, and the somatosensory cortex. However, it is unclear if such a dysfunction is somato-specific to the brain areas containing the representation of the affected body part, and may thereby account for the focal expression of cervical dystonia. In this study, we investigated resting state functional connectivity in the areas within the motor cortex and the cerebellum containing affected and non-affected body representations in cervical dystonia patients. METHODS Eighteen patients affected by cervical dystonia and 21 healthy controls had resting state fMRI. The functional connectivity between the motor cortex and the cerebellum, as well as their corresponding measures of gray matter volume and cortical thickness, were compared between groups. We performed seed-based analyses, selecting the different body representation areas in the precentral gyrus as seed regions, and all cerebellar areas as target regions. RESULTS Compared to controls, patients exhibited increased functional connectivity between the bilateral trunk representation area of the motor cortex and the cerebellar vermis 6 and 7b, respectively. These functional abnormalities did not correlate with structural changes or symptom severity. CONCLUSIONS Our findings indicate that the abnormal function of the motor network is somato-specific to the areas encompassing the neck representation. Functional abnormalities in discrete relevant areas of the motor network could thus contribute to the focal expression of CD.
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Affiliation(s)
- Giuseppe A Zito
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Clément Tarrano
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, 47-83 Boulevard de l'Hôpital, 75013, Paris, France; Department of Neurology, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Prasanthi Jegatheesan
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Asya Ekmen
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Benoît Béranger
- Center for NeuroImaging Research CENIR, Paris Brain Institute, Sorbonne University, UPMC Univ Paris 06, Inserm U1127, CNRS UMR 7225, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Michael Rebsamen
- Support Center for Advanced Neuroimaging SCAN, University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, CH, Switzerland.
| | - Cécile Hubsch
- Department of Neurology, Rothschild Foundation, 25-29 Rue Manin, 75019, Paris, France.
| | - Sophie Sangla
- Department of Neurology, Rothschild Foundation, 25-29 Rue Manin, 75019, Paris, France.
| | - Cécilia Bonnet
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Cécile Delorme
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, 47-83 Boulevard de l'Hôpital, 75013, Paris, France; Department of Neurology, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Aurélie Méneret
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, 47-83 Boulevard de l'Hôpital, 75013, Paris, France; Department of Neurology, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Bertrand Degos
- Neurology Unit, Assistance Publique-Hôpitaux de Paris, Avicenne University Hospital, Sorbonne Paris Nord, 125 Rue de Stalingrad, 93000, Bobigny, France; Center for Interdisciplinary Research in Biology, Collège de France, Inserm U1050, CNRS UMR 7241, PSL University, 11 place Marcelin Berthelot, 75231, Paris, France.
| | - Floriane Bouquet
- Department of Neurology, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Marion Apoil Brissard
- Department of Neurology, University of Caen Normandie Hospital Center, Av. de la Côte de Nacre, 14000, Caen, France.
| | - Marie Vidailhet
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, 47-83 Boulevard de l'Hôpital, 75013, Paris, France; Department of Neurology, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Cécile Gallea
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Emmanuel Roze
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, 47-83 Boulevard de l'Hôpital, 75013, Paris, France; Department of Neurology, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Yulia Worbe
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, 47-83 Boulevard de l'Hôpital, 75013, Paris, France; Department of Neurophysiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France.
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Zeuner KE, Knutzen A, Granert O, Trampenau L, Baumann A, Wolff S, Jansen O, van Eimeren T, Kuhtz-Buschbeck JP. Never too little: Grip and lift forces following probabilistic weight cues in patients with writer's cramp. Clin Neurophysiol 2021; 132:2937-2947. [PMID: 34715418 DOI: 10.1016/j.clinph.2021.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/03/2021] [Accepted: 09/05/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Planning of voluntary object-related movements requires the estimation of the most probable object properties. We investigated how 14 writer's cramp (WC) patients compared to 14 controls use probabilistic weight cues in a serial grip-lift task. METHODS In every grip-lift trial, an object of either light, medium or heavy weight had to be grasped and lifted after a visual cue gave a probabilistic prediction of the object weights (e.g. 32.5% light, 67.5% medium, 0 % heavy). We determined peak (1) grip force GF, (2) load force LF, (3) grip force rate GFR, (4) load force rate LFR, while we registered brain activity with functional magnetic resonance imaging. RESULTS In both groups, GFR, LFR and GF increased when a higher probability of heavy weights was announced. When a higher probability of light weights was indicated, controls reduced GFR, LFR and GF, while WC patients did not downscale their forces. There were no inter-group differences in blood oxygenation level dependent activation. CONCLUSIONS WC patients could not utilize the decision range in motor planning and adjust their force in a probabilistic cued fine motor task. SIGNIFICANCE The results support the pathophysiological model of a hyperfunctional dopamine dependent direct basal ganglia pathway in WC.
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Affiliation(s)
| | - Arne Knutzen
- Department of Neurology, Kiel University, Germany
| | | | | | | | - Stephan Wolff
- Department of Radiology and Neuroradiology, Kiel University, Germany
| | - Olav Jansen
- Department of Radiology and Neuroradiology, Kiel University, Germany
| | - Thilo van Eimeren
- Department of Nuclear Medicine, University Hospital Cologne, Germany
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Kita K, Furuya S, Osu R, Sakamoto T, Hanakawa T. Aberrant Cerebello-Cortical Connectivity in Pianists With Focal Task-Specific Dystonia. Cereb Cortex 2021; 31:4853-4863. [PMID: 34013319 DOI: 10.1093/cercor/bhab127] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Musician's dystonia is a type of focal task-specific dystonia (FTSD) characterized by abnormal muscle hypercontraction and loss of fine motor control specifically during instrument playing. Although the neuropathophysiology of musician's dystonia remains unclear, it has been suggested that maladaptive functional abnormalities in subcortical and cortical regions may be involved. Here, we hypothesized that aberrant effective connectivity between the cerebellum (subcortical) and motor/somatosensory cortex may underlie the neuropathophysiology of musician's dystonia. Using functional magnetic resonance imaging, we measured the brain activity of 30 pianists with or without FTSD as they played a magnetic resonance imaging-compatible piano-like keyboard, which elicited dystonic symptoms in many but not all pianists with FTSD. Pianists with FTSD showed greater activation of the right cerebellum during the task than healthy pianists. Furthermore, patients who reported dystonic symptoms during the task demonstrated greater cerebellar activation than those who did not, establishing a link between cerebellar activity and overt dystonic symptoms. Using multivoxel pattern analysis, moreover, we found that dystonic and healthy pianists differed in the task-related effective connectivity between the right cerebellum and left premotor/somatosensory cortex. The present study indicates that abnormal cerebellar activity and cerebello-cortical connectivity may underlie the pathophysiology of FTSD in musicians.
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Affiliation(s)
- Kahori Kita
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan.,Center for Frontier Medical Engineering, Chiba University, Chiba 263-8522, Japan.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Shinichi Furuya
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan.,Musical Skill and Injury Center, Sophia University, Tokyo 102-8554, Japan.,Sony Computer Science Laboratories Inc., Tokyo 141-0022, Japan
| | - Rieko Osu
- Faculty of Human Sciences, Waseda University, Saitama 359-1192, Japan
| | - Takashi Sakamoto
- Department of Neurology, National Center of Neurology and Psychiatry Hospital, Tokyo 187-8551, Japan
| | - Takashi Hanakawa
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan.,Integrated Neuroanatomy and Neuroimaging, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
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Abstract
Overuse of specific muscles in perfecting movements in performing arts makes an artist prone to many medical conditions. Musicians' hand dystonia is focal task-specific dystonia (FTSD) of hand among musicians that has been extensively studied. However, embouchure, lower limbs, and laryngeal muscles can also be affected among musicians. Embouchure dystonia (ED) refers to dystonia of the perioral and facial muscles that occurs in musicians while playing embouchure instruments. It is essential to identify ED since the dystonia might become persistent and non-task-specific if the musician continues to play the instrument. Task-specific dystonia of lower limbs among musicians has been exclusively reported among drummers. The diagnosis rests on electromyogram (EMG) of the involved muscles during the task. Singer's dystonia (SD) refers to task-specific laryngeal dystonia that occurs only while singing. The diagnosis of SD is based on laryngeal EMG and spectrographic analysis. Cortical hyperexcitability, loss of inhibition, and aberrant plasticity are central to the pathogenesis in both ED and musicians' hand dystonia. The pathophysiological studies in SD are limited. This review aims to discuss the lesser known dystonias among performing artists - ED, FTSD of lower limb, and SD.
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Mantel T, Altenmüller E, Li Y, Lee A, Meindl T, Jochim A, Zimmer C, Haslinger B. Structure-function abnormalities in cortical sensory projections in embouchure dystonia. NEUROIMAGE-CLINICAL 2020; 28:102410. [PMID: 32932052 PMCID: PMC7495104 DOI: 10.1016/j.nicl.2020.102410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/29/2020] [Accepted: 08/30/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Embouchure dystonia (ED) is a task-specific focal dystonia in professional brass players leading to abnormal orofacial muscle posturing/spasms during performance. Previous studies have outlined abnormal cortical sensorimotor function during sensory/motor tasks and in the resting state as well as abnormal cortical sensorimotor structure. Yet, potentially underlying white-matter tract abnormalities in this network disease are unknown. OBJECTIVE To delineate structure-function abnormalities within cerebral sensorimotor trajectories in ED. METHOD Probabilistic tractography and seed-based functional connectivity analysis were performed in 16/16 ED patients/healthy brass players within a simple literature-informed network model of cortical sensorimotor processing encompassing supplementary motor, superior parietal, primary somatosensory and motor cortex as well as the putamen. Post-hoc grey matter volumetry was performed within cortices of abnormal trajectories. RESULTS ED patients showed average axial diffusivity reduction within projections between the primary somatosensory cortex and putamen, with converse increases within projections between supplementary motor and superior parietal cortex in both hemispheres. Increase in the mode of anisotropy in patients was accompanying the latter left-hemispheric projection, as well as in the supplementary motor area's projection to the left primary motor cortex. Patient's left primary somatosensory functional connectivity with the putamen was abnormally reduced and significantly associated with the axial diffusivity reduction. Left primary somatosensory grey matter volume was increased in patients. CONCLUSION Correlates of abnormal tract integrity within primary somatosensory cortico-subcortical projections and higher-order sensorimotor projections support the key role of dysfunctional sensory information propagation in ED pathophysiology. Differential directionality of cortico-cortical and cortico-subcortical abnormalities hints at non-uniform sensory system changes.
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Affiliation(s)
- Tobias Mantel
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Eckart Altenmüller
- Hochschule für Musik, Theater und Medien Hannover, Emmichplatz 1, Hanover, Germany
| | - Yong Li
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - André Lee
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany; Hochschule für Musik, Theater und Medien Hannover, Emmichplatz 1, Hanover, Germany
| | - Tobias Meindl
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Angela Jochim
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Claus Zimmer
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Bernhard Haslinger
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany.
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Hirsig A, Barbey C, Schüpbach MW, Bargiotas P. Oculomotor functions in focal dystonias: A systematic review. Acta Neurol Scand 2020; 141:359-367. [PMID: 31990980 DOI: 10.1111/ane.13224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 01/09/2020] [Accepted: 01/20/2020] [Indexed: 12/20/2022]
Abstract
Focal Dystonia (FD) is a chronic neurological disorder, which causes twisting and repetitive movements and abnormal postures induced by involuntary sustained contractions of agonist and antagonist muscles. Based on the hypothesis that several dystonia-related brain regions, including cerebellum, are implicated in oculomotor disturbances (OCD), a number of studies investigated oculomotor function in patients with dystonia. However, conceptual clarity with respect to the used assessment tools and interpretation of the findings is lacking in the literature. This is the first article to systematically review studies that assessed oculomotor function in patients with FD. In total, 329 publications, published until September 1, 2019, were identified through MEDLINE search. Twenty out of 329 studies, involving 232 subjects in total, met the inclusion criteria. Most of the studies reported oculomotor disturbances in patients with FD. Abnormalities included asymmetry in vestibulo-ocular reflex (VOR), disturbances in saccadic functions, and prolonged latencies of eye motion. Discrepancies in the results could be explained, at least partially, by the long period of time over which the reviewed studies were published, the different methods used for testing the eye movements, and the limited number of patients assessed since the majority of data derived from case reports or small-scale studies. Further prospective studies with larger subject numbers are needed, using advanced tools for the assessment of oculomotor function in focal dystonia.
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Affiliation(s)
- Anna Hirsig
- Department of Neurology University Hospital (Inselspital) and University of Bern Bern Switzerland
| | - Carolin Barbey
- Department of Neurology University Hospital (Inselspital) and University of Bern Bern Switzerland
| | - Michael W.M. Schüpbach
- Department of Neurology University Hospital (Inselspital) and University of Bern Bern Switzerland
| | - Panagiotis Bargiotas
- Department of Neurology University Hospital (Inselspital) and University of Bern Bern Switzerland
- Department of Neurology Medical School University of Cyprus Nicosia Cyprus
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Neuropathology and pathogenesis of extrapyramidal movement disorders: a critical update. II. Hyperkinetic disorders. J Neural Transm (Vienna) 2019; 126:997-1027. [DOI: 10.1007/s00702-019-02030-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/14/2019] [Indexed: 12/14/2022]
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Mantel T, Altenmüller E, Li Y, Meindl T, Jochim A, Lee A, Zimmer C, Dresel C, Haslinger B. Abnormalities in grey matter structure in embouchure dystonia. Parkinsonism Relat Disord 2019; 65:111-116. [PMID: 31147222 DOI: 10.1016/j.parkreldis.2019.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/19/2019] [Accepted: 05/05/2019] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Embouchure dystonia (ED) is a debilitating movement disorder in professional brass players leading to involuntary muscle contractions/spasms during play. To date, activity changes in sensorimotor cortices during motor tasks and tactile processing, as well as connectivity changes at rest in sensorimotor and auditory brain networks have been described in the disease. OBJECTIVE To characterize differences in grey matter volume and asymmetry between brass musicians suffering from ED, healthy brass musicians and healthy nonmusicians. METHODS High-resolution structural magnetic resonance imaging was obtained from 24 brass musicians with ED, 23 healthy brass musicians and 24 healthy nonmusicians. Whole-brain voxel-wise morphometry and asymmetry analyses, as well as region-of-interest-based volumetry analysis were performed on the subjects' images and compared between groups. Further, correlations with clinical parameters were investigated. RESULTS ED patients showed increased grey matter volume in the primary sensorimotor cortex in relation to both healthy brass players and nonmusicians. Both healthy and diseased musicians showed increased thalamic symmetry in relation to nonmusicians; diseased brass musicians additionally showed increased basal ganglia symmetry compared to nonmusicians. There was an inverse correlation of disease duration with both mean putaminal volume and the extent of basal ganglia asymmetry. CONCLUSION This work provides first evidence for structural abnormalities in task-specific orofacial (musician's) dystonia. Somatotopy-related structural primary sensorimotor cortex changes underlying previously observed functional abnormalities underscore the role of maladaptive plasticity in the disease. The study further shows subcortical brain (a)symmetry changes in healthy brass players and hints at a possible role of such changes in focal dystonia.
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Affiliation(s)
- Tobias Mantel
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Eckart Altenmüller
- Hochschule für Musik, Theater und Medien Hannover, Emmichplatz 1, Hanover, Germany
| | - Yong Li
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Tobias Meindl
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Angela Jochim
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - André Lee
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Claus Zimmer
- Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany
| | - Christian Dresel
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany; Department of Neurology, Johannes Gutenberg University, Langenbeckstrasse 1, Mainz, Germany
| | - Bernhard Haslinger
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstrasse 22, Munich, Germany.
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Uehara K, Furuya S, Numazawa H, Kita K, Sakamoto T, Hanakawa T. Distinct roles of brain activity and somatotopic representation in pathophysiology of focal dystonia. Hum Brain Mapp 2019; 40:1738-1749. [PMID: 30570801 DOI: 10.1002/hbm.24486] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/25/2018] [Accepted: 11/21/2018] [Indexed: 12/18/2022] Open
Abstract
Two main neural mechanisms including loss of cortical inhibition and maladaptive plasticity have been thought to be involved in the pathophysiology of focal task-specific dystonia. Such loss of inhibition and maladaptive plasticity likely correspond to cortical overactivity and disorganized somatotopy, respectively. However, the most plausible mechanism of focal task-specific dystonia remains unclear. To address this question, we assessed brain activity and somatotopic representations of motor-related brain areas using functional MRI and behavioral measurement in healthy instrumentalists and patients with embouchure dystonia as an example of focal task-specific dystonia. Dystonic symptoms were measured as variability of fundamental frequency during long tone playing. We found no significant differences in brain activity between the embouchure dystonia and healthy wind instrumentalists in the motor-related areas. Assessment of somatotopy, however, revealed significant differences in the somatotopic representations of the mouth area for the right somatosensory cortex between the two groups. Multiple-regression analysis revealed brain activity in the primary motor and somatosensory cortices, cerebellum, and putamen was significantly associated with variability of fundamental frequency signals representing dystonic symptoms. Conversely, somatotopic representations in motor-related brain areas were not associated with variability of fundamental frequency signals in embouchure dystonia. The present findings suggest that abnormal motor-related network activity and aberrant somatotopy correlate with different aspects of mechanisms underlying focal task-specific dystonia.
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Affiliation(s)
- Kazumasa Uehara
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center (IBIC), National Center of Neurology and Psychiatry, Tokyo, Japan.,Musical Skill and Injury Center (MuSIC), Sophia University, Tokyo, Japan.,Research fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Shinichi Furuya
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center (IBIC), National Center of Neurology and Psychiatry, Tokyo, Japan.,Musical Skill and Injury Center (MuSIC), Sophia University, Tokyo, Japan.,Sony Computer Science Laboratories Inc. (Sony CSL), Tokyo, Japan
| | - Hidemi Numazawa
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center (IBIC), National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kahori Kita
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center (IBIC), National Center of Neurology and Psychiatry, Tokyo, Japan.,Musical Skill and Injury Center (MuSIC), Sophia University, Tokyo, Japan.,Center for Frontier Medical Engineering, Chiba University, Chiba, Japan
| | - Takashi Sakamoto
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takashi Hanakawa
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center (IBIC), National Center of Neurology and Psychiatry, Tokyo, Japan.,Musical Skill and Injury Center (MuSIC), Sophia University, Tokyo, Japan
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