Increased functional connectivity of motor regions and dorsolateral prefrontal cortex in musicians with focal hand dystonia

BackgroundMusician's dystonia is the most common form of focal task-specific dystonia and is suggested to be the result of dysfunctional communication among sensory-motor networks. Thus far, few functional connectivity studies have investigated musician's dystonia specifically, leaving its exact pathophysiological mechanisms unclear. The goal of this study was to verify connectivity findings from other task-specific dystonias on a large sample of musician's hand dystonia patients and to analyze associations with possible adverse childhood experiences, a suggested risk factor for dystonia.MethodsForty professional musicians suffering from musician's hand dystonia and a matched control group of healthy musicians underwent resting-state functional magnetic resonance imaging and answered the childhood trauma questionnaire. Using a seed-to-whole brain approach, functional connectivity alterations between motor cortices, the prefrontal cortex, the basal ganglia and the thalamus were analyzed.ResultsMusician's dystonia patients showed increased functional connectivity of the dorsolateral prefrontal cortex with the putamen and the pallidum, especially in right-side affected patients. Patients further displayed increased connectivity of the left thalamus and the right lateral premotor cortex. No associations between functional connectivity, duration of disorder and childhood adversity were observed.ConclusionThe findings are consistent with previous research, highlighting the pathophysiological importance of the basal ganglia. Altered resting-state functional connectivity may reflect underlying neuroplastic changes in musicians with dystonia that lead to an altered flow of information, disrupting movement inhibition. Involvement of the dorsolateral prefrontal and premotor cortices further suggests that motor disturbances occur in the early planning phase of a movement. The findings indicate that a holistic re-training approach with and without the instrument could be beneficial for regaining motor control.