Objective Evaluation of Performance Stress in Musicians With Focal Hand Dystonia: A Case Series

ABSTRACT

Five musicians suffering from focal dystonia participated in a pilot study that examined the feasibility of an experimental protocol designed to assess musicians' motor performance under stress. Electrocardiography, free cortisol levels, and subjective assessments were used to monitor alterations of the hypothalamic-pituitary-adrenal axis. As measures of motor outcome, temporal variability of finger movements and muscular cocontraction of the wrist flexor and extensor were assessed. Findings suggest that the specific experimental design could be successfully applied. Several methodological issues such as carryover effects, the use of free cortisol, the inclusion of a double baseline, and the classification of dystonic patients into stress responders and nonresponders are analyzed and discussed.

Keywords:

• electrophysiology
• focal dystonia
• free cortisol
• motor performance
• stress

ACKNOWLEDGMENTS

The authors are grateful to all members of the IMMM for their beneficial feedback and insights and especially to Dr. Michael Großbach and Martin Neubauer for their technical support for the whole project.

FUNDING

The overall study is funded by the German Research Foundation (DFG) (AL 269/8-1).