Dysfunctional Motor Automaticity in Focal Hand Dystonia in Musicians

描述(申请人提供)：肌张力障碍是一种神经运动障碍，以持续或间歇性肌肉收缩为特征，导致不必要的不自主运动。这种疾病可能是局灶性的(影响一个身体区域)，也可能是更普遍的；这两个实体可能有不同的病因。局灶性手部肌张力障碍(FHD)的特征是手指和手的非随意肌肉收缩。它在器乐演奏家中的发生率有所增加，当它发生在专业音乐家身上时，通常是职业生涯的终结。患有FHD的音乐家表现出运动学习的缺陷，以及与自动运动控制相关的大脑结构激活不足。运动序列的学习和执行通常被认为是在认知或自动控制下进行的；认知控制需要注意运动动作，而自动执行则允许执行功能的自由。当演奏乐器时，音乐家既需要对手指运动的认知控制，也需要对手指运动的自动控制，所以精致的演奏很可能发生在这两种控制机制的界面上。本项目将研究自动控制和认知控制在FHD中的作用。总的假设是，FHD是由认知和自动控制特定过度学习任务之间的交界处的神经回路受损造成的。此外，在非局限性形式的肌张力障碍中，这种界面可能受到的影响较小。患有FHD的音乐家、年龄匹配的没有肌张力障碍的音乐家、有手部非局限性肌张力障碍的非音乐家以及没有肌张力障碍的非音乐家将戴着器乐手套执行一系列连续的手指敲击任务，以记录详细的运动运动学。这些任务将探索认知控制和自动控制之间的不同变量：敲击速度、保持力和对潜在序列模式的明确了解。研究结果将提供有关音乐家失去运动控制的神经回路的重要信息。 使用FHD。具有直接实际意义的是，该项目的结果将决定基于认知策略的治疗是否可以为患有FHD的音乐家提供好处。未来的研究将涉及将这些发现应用于需要高重复的技能学习背景下的保护性学习策略。

DESCRIPTION (provided by applicant): Dystonia is a neurological movement disorder characterized by sustained or intermittent muscle contractions causing unwanted involuntary movements. The disorder may be focal (affecting one body region) or more generalized; it is likely that the two entities have different etiologies. Focal hand dystonia (FHD) is characterized by involuntary muscle contractions in the fingers and hand. It has increased incidence in instrumental musicians, and, when it occurs in the professional, is usually career ending. Musicians with FHD demonstrate deficiencies in motor learning and an under-activation of brain structures associated with automatic motor control. Motor sequence learning and performance is generally thought to be either under cognitive or automatic control; cognitive control requires attention directed to the motor movements while automatic performance allows freedom for executive function. When playing an instrument, musicians require both cognitive and automatic control over finger movements, so exquisite performance likely takes place at the interface of these two control mechanisms. This project will investigate the role of automatic and cognitive control in FHD. The overall hypothesis is that FHD results from impaired neural circuitry at the interface between cognitive and automatic control of a specific over-learned task. Furthermore, this interface is likely to be less affected in non-focal forms of dystonia. Musicians with FHD, age-matched musicians without dystonia, non-musicians with non-focal dystonia that involve the hand, and non-musicians without dystonia will perform a battery of sequential finger-tapping tasks while wearing an instrumented glove to record detailed movement kinematics. The tasks will probe the variables that differ between cognitive and automatic control: tapping speed, retention, and explicit knowledge of underlying sequence patterns. The results will provide important information about the neural circuitry responsible for loss of motor control in musicians with FHD. Of immediate practical importance, the results of this project will determine whether a cognitive strategy-based therapy may provide benefit for musicians with FHD. Future studies will involve application of these findings to protective learning strategies in the context of skil learning requiring high repetition.