Combined effects of a Mediterranean diet and respiratory muscle training on higher education woodwind musicians: A randomized controlled trial.

A two-factor within subjects and randomized controlled was conducted with three groups (two experimental and one control) to explore the effects of the Mediterranean diet and respiratory muscle training on ventilatory fatigue, stress, and emotional performance of woodwind musicians. 70 students from the Valencia Conservatory of Music were recruited and randomized into three groups: respiratory training group + nutrition program (RTG; n = 17), control group (CG; n = 35) and nutrition program group (NPG; n = 18). The nutritional program was based on Mediterranean a diet. Body composition, emotional intelligence, physiological stress and ventilatory response were assessed for all groups before and after intervention. Mixed ANOVA showed main effects of diet and training interventions on emotional attention (F = 8.042; p = 0.006), clarity (F = 9.306; p = 0.003), repair (F = 5.527; p = 0.022), Forced-Expiratory-Volume (F = 30.196; p < 0.000) and Forced-Vital-Capacity (F = 21.052; p < 0.000), with both interventions improving emotional intelligence and ventilatory variables. Bonferroni post-hoc analysis revealed significant differences of RTG and CG for emotional attention (MD = 4.60; p = 0.023), comprehension (MD = 5.734; p = 0.005), repair (MD = 8.576; p < 0.000), FEV1 (MD = 0.862; p = 0.005), and FCV (MD = 1.608; p < 0.001); with similar results when comparing NTG and CG: emotional attention (MD = 4.156; p = 0.041), comprehension (MD = 4.473; p = 0.033), repair (MD = 6.511; p = 0.001), Forced-Expiratory-Volume (MD = 1.608; p < 0.001), and Forced-Vital-Capacity (MD = 1.183; p < 0.001). No significant effects of experimental groups were observed for physiological stress variables (p > 0.05). This results suggests that respiratory training enhances emotional intelligence and lessens respiratory fatigue in musicians, and a combination of a Mediterranean diet and respiratory muscle training further boosts emotional intelligence, albeit with limited impact on physiological stress. This study represents a novel investigation into the approach by dietary interventions and respiratory muscle training in wind musicians since there are no studies that analyze it.

Factors Associated with Performance-Related Pain Among Musicians: A Multicenter Study Using Validated Tools.

PURPOSE: We aimed to evaluate factors associated with performance-related pain among musicians with different backgrounds, comparing music students and professional musicians. METHODS: We performed a multicenter cross-sectional study in a stratified random sample consisting of music students (294) and professional musicians (291). The main outcome was performance-related pain (PRP), measured by the Performance-related Pain among Musicians Questionnaire (PPAM). Factors associated with the outcome were measured using PPAM, International Physical Activity Questionnaire, Modified Fatigue Impact Scale, 10-item Kessler Psychological Distress Scale, Frost Multidimensional Perfectionism Scale, and Medical Outcomes Study Short Form 36 Health Survey. RESULTS: From the 585 musicians included (response rate of 82.4%), 322 (55.0%) reported PRP. Professional musicians presented a significantly higher lifetime prevalence of PRP (57.5%, p < 0.001); however, music students reported higher levels of fatigue, anxiety and depression, and lower quality of life. Multivariate logistic regression defined a model with 16 factors significantly associated with higher probability of PRP. Additionally, we describe 25 self-perceived factors reported by musicians as being associated with PRP. CONCLUSION: We present the first study thoroughly describing and assessing factors associated with PRP among musicians, using a validated tool, including musicians with different backgrounds, and distinguishing music students and professional musicians. We also explore self-perceived factors associated with PRP. The relevant insights coming from this and future studies on factors associated with PRP will contribute to developing more effective preventive programs and improving evidence-based guidance and management of musicians affected by PRP.

A longitudinal study investigating the effects of noise exposure on behavioural, electrophysiological and self-report measures of hearing in musicians with normal audiometric thresholds.

Musicians are at risk of hearing loss and tinnitus due to regular exposure to high levels of noise. This level of risk may have been underestimated previously since damage to the auditory system, such as cochlear synaptopathy, may not be easily detectable using standard clinical measures. Most previous research investigating hearing loss in musicians has involved cross-sectional study designs that may capture only a snapshot of hearing health in relation to noise exposure. The aim of this study was to investigate the effects of cumulative noise exposure on behavioural, electrophysiological, and self-report indices of hearing damage in early-career musicians and non-musicians with normal hearing over a 2-year period. Participants completed an annual test battery consisting of pure tone audiometry, extended high-frequency hearing thresholds, distortion product otoacoustic emissions (DPOAEs), speech perception in noise, auditory brainstem responses, and self-report measures of tinnitus, hyperacusis, and hearing in background noise. Participants also completed the Noise Exposure Structured Interview to estimate cumulative noise exposure across the study period. Linear mixed models assessed changes over time. The longitudinal analysis comprised 64 early-career musicians (female n = 34; age range at T0 = 18-26 years) and 30 non-musicians (female n = 20; age range at T0 = 18-27 years). There were few longitudinal changes as a result of musicianship. Small improvements over time in some measures may be attributable to a practice/test-retest effect. Some measures (e.g., DPOAE indices of outer hair cell function) were associated with noise exposure at each time point, but did not show a significant change over time. A small proportion of participants reported a worsening of their tinnitus symptoms, which participants attributed to noise exposure, or not using hearing protection. Future longitudinal studies should attempt to capture the effects of noise exposure over a longer period, taken at several time points, for a precise measure of how hearing changes over time. Hearing conservation programmes for "at risk" individuals should closely monitor DPOAEs to detect early signs of noise-induced hearing loss when audiometric thresholds are clinically normal.

Impact of Medical Cannabis on Recovery from Playing-Related Musculoskeletal Disorders in Musicians: An Observational Cohort Study.

INTRODUCTION: Playing-related musculoskeletal disorders (PRMDs) are musculoskeletal symptoms that interfere with the ability to play at the level a musician is accustomed to. Musicians have an 84% lifetime prevalence of PRMD. Many types of analgesia are inappropriate for this population due to their risks, but cannabidiol (CBD) has been shown to have anti-inflammatory properties and can reduce the perception of pain. Medical cannabis has also been shown to be safer than other analgesia in terms of serious adverse events. This study explores the impact of medical cannabis for PRMD on perceptions of pain and mental health outcomes. METHODS: Participants (n = 204) completed questionnaires at baseline and six months: the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM) and Depression, Anxiety and Stress Scale (DASS-21). Participants self-selected their group: non-cannabis users (n = 42), new medical cannabis users (n = 61), and long-term medical cannabis users (n = 101). Data were analyzed using paired t-tests for within-group and ANOVA for between-group differences. RESULTS: At six months, there was no difference (p = 0.579) in cannabidiol dose between new (24.87 ± 12.86 mg) and long-term users (21.48 ± 12.50 mg). There was a difference in tetrahydrocannabinol (THC) dose (p = 0.003) between new (3.74 ± 4.22 mg) and long-term users (4.41 ± 5.18 mg). At six months, new cannabis users had a significant reduction in pain intensity as measured by The Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM40) (p = 0.002). Non-users (p = 0.035), new users (p = 0.002), and long-term cannabis users (p = 0.009) all had significant reductions in pain interference (MPIIQM50) at six months. At six months, non-cannabis (p = 0.022) and long-term cannabis users (p = 0.001) had an improvement in DASS-21. The change in pain intensity was the only difference between groups, F(2, 201) = 3.845, p = 0.023. This difference was between long-term (0.83 ± 0.79) and new users (-2.61 ± 7.15). No serious adverse events occurred, and a minority experienced tiredness, cough, and dry mouth. DISCUSSION/CONCLUSIONS: This practice-based evidence demonstrated that the multidimensional approach to care provided by the Musicians' Clinics of Canada benefited all groups at six months. Medical cannabis significantly reduced pain intensity in new users of medical cannabis with PRMD, and all groups saw improvements in pain interference. In keeping with prior studies, medical cannabis seems to be effective at reducing perceptions of pain, including for PRMD. CBD/THC dosing was within guideline recommendations, and no patients experienced any serious adverse events. Limitations include multiple factors impacting patients' decisions to opt in or out of medical cannabis. These include cost, comorbidities, and disease chronicity. In conclusion, medical cannabis reduces pain intensity in new users, and when combined with a multidimensional approach to care, patients with PRMD can see improvements in pain as well as mental wellbeing.

Efficacy of Therapeutic Exercise in Reducing Pain in Instrumental Musicians: Systematic Review and Meta-Analysis.

Playing-related pain poses a significant health concern for musicians, often impacting their ability to perform. Therapeutic exercise emerges as a viable approach to alleviate these symptoms, offering a low-cost intervention with minimal side effects. This review seeks to examine and assess the efficacy of therapeutic exercise in reducing pain intensity among instrumental musicians. Three major databases (PubMed, Web of Science, and Scopus) were systematically searched from November 2023 to June 2024. The inclusion criteria required studies to be randomized clinical trials focusing on pain intensity in instrumental musicians, published in the last 10 years. Two independent researchers assessed the characteristics and methodological quality of the selected studies. Out of 305 identified studies, 15 underwent full-text reviews, with 5 ultimately included in the analysis. The total participant count was 273, with an average intervention duration of 32.5 min per session, twice weekly for eight weeks. Overall, therapeutic exercise interventions demonstrated favorable effects, with three studies exhibiting good methodological quality. The meta-analysis revealed significant positive results favoring exercise in reducing pain intensity, with positive responses observed across all clinical populations, so therapeutic exercise appears to be an effective approach for reducing pain intensity in musicians experiencing playing-related pain.

Boundaries of task-specificity: bimanual finger dexterity is reduced in musician's dystonia.

Task-specific dystonia leads to loss of sensorimotor control for a particular motor skill. Although focal in nature, it is hugely disabling and can terminate professional careers in musicians. Biomarkers for underlying mechanism and severity are much needed. In this study, we designed a keyboard device that measured the forces generated at all fingertips during individual finger presses. By reliably quantifying overflow to other fingers in the instructed (enslaving) and contralateral hand (mirroring) we explored whether this task could differentiate between musicians with and without dystonia. 20 right-handed professional musicians (11 with dystonia) generated isometric flexion forces with the instructed finger to match 25%, 50% or 75% of maximal voluntary contraction for that finger. Enslaving was estimated as a linear slope of the forces applied across all instructed/uninstructed finger combinations. Musicians with dystonia had a small but robust loss of finger dexterity. There was increased enslaving and mirroring, primarily during use of the symptomatic hand (enslaving p = 0.003; mirroring p = 0.016), and to a lesser extent with the asymptomatic hand (enslaving p = 0.052; mirroring p = 0.062). Increased enslaving and mirroring were seen across all combinations of finger pairs. In addition, enslaving was exaggerated across symptomatic fingers when more than one finger was clinically affected. Task-specific dystonia therefore appears to express along a gradient, most severe in the affected skill with subtle and general motor control dysfunction in the background. Recognition of this provides a more nuanced understanding of the sensorimotor control deficits at play and can inform therapeutic options for this highly disabling disorder.

Auditory associative word learning in adults: The effects of musical experience and stimulus ordering.

Evidence for sequential associative word learning in the auditory domain has been identified in infants, while adults have shown difficulties. To better understand which factors may facilitate adult auditory associative word learning, we assessed the role of auditory expertise as a learner-related property and stimulus order as a stimulus-related manipulation in the association of auditory objects and novel labels. We tested in the first experiment auditorily-trained musicians versus athletes (high-level control group) and in the second experiment stimulus ordering, contrasting object-label versus label-object presentation. Learning was evaluated from Event-Related Potentials (ERPs) during training and subsequent testing phases using a cluster-based permutation approach, as well as accuracy-judgement responses during test. Results revealed for musicians a late positive component in the ERP during testing, but neither an N400 (400-800 ms) nor behavioral effects were found at test, while athletes did not show any effect of learning. Moreover, the object-label-ordering group only exhibited emerging association effects during training, while the label-object-ordering group showed a trend-level late ERP effect (800-1200 ms) during test as well as above chance accuracy-judgement scores. Thus, our results suggest the learner-related property of auditory expertise and stimulus-related manipulation of stimulus ordering modulate auditory associative word learning in adults.

Prevalence of musculoskeletal pain and associated factors among professional orchestra musicians in Norway.

BACKGROUND: Orchestra musicians have a high risk of experiencing musculoskeletal problems. These problems may lead to sleep and psychological disturbance. OBJECTIVES: This study investigated the occurrence of musculoskeletal pain (MSP) among orchestra musicians and the coherence between pain and predictors such as gender, age and instrument. Further, the impact of pain on sleep and mental health was analysed to assess pain as a predictor threatening musicians' wellbeing. METHODS: Some 358 musicians in eight different professional orchestras in Norway completed a questionnaire. Questions about pain experienced within the last 30 days were based on a national survey. Standardised screening tools like the Hopkins Symptom Checklist-25 (HSCL-25) and Bergen Insomnia Scale (BIS) were used to assess psychological distress and sleeping problems. Kruskal-Wallis tests were used to analyse the differences in the pain-related variables: experienced pain severity (EPS), number of pain areas, and work being perceived as the source of pain based on age. Mann-Whitney U tests were conducted to evaluate the statistical significance between gender and the pain-related variables. Spearman's rank correlations were used to examine the relationship between EPS and BIS, HSCL-25 and pain area. Additionally, simple linear regression models were employed to determine whether EPS can predict higher scores on the HSCL-25 and BIS scales. RESULTS: The prevalence of MSP experienced in the last 30 days among orchestra musicians in Norway was 85%. Musicians experienced frequent pain regardless of their gender, age or instrument group. Neck, shoulders and upper back represented the most reported pain areas. Further, it was observed that increased EPS was correlated with an increase in the number of pain areas and in work being perceived as the source of pain. EPS significantly predicted sleep- and psychological distress. CONCLUSIONS: Orchestra musicians have a high risk of encountering MSP. Furthermore, their psychological distress and sleeping problems seem to be related to experienced MSP. To deliver optimal health, these problems should be handled simultaneously.

Focal dystonia in musicians, a literature review.

BACKGROUND: Musician's focal dystonia (mFD) is a rare, neurological, task-specific disorder that mainly affects the upper extremity (especially the hands) and generally appears as a painless muscular incoordination that can mark the end of a musician's professional career. The present literature review intends to highlight the current understanding of musician's focal dystonia, its underlying neural mechanisms and the role of prevention and treatment in physiotherapy, psychotherapy and other fields as occupational therapy. PURPOSE: The aim of the present literature review was to gain an overview of mFD in the medical, psychological and physical therapy literature and investigate what strategies for diagnosis and rehabilitation are available today. STUDY DESIGN: The present article is a literature review, based on the search for full-text publications with the goal of comparing the main strategies for mFD rehabilitation and prevention presented in the literature. METHODS: This literature review compared many relevant papers and studies available in literature today for mFD epidemiology, neural mechanisms, treatment and prevention, to discuss what we know today and highlight the aspects that can still be enhanced in the future. RESULTS: According to our results, current literature gives a good understanding of mFD epidemiology, but further studies are needed to fully comprehend the neurological aspects and develop more rehabilitation strategies, especially in the psychological field. Our research also highlighted the need for a multidisciplinary approach that considers both physical and psychological aspects. CONCLUSIONS: Physical rehabilitation strategies are helpful but, considering the amount of psychological aspects involved in mFD, a holistic approach should be considered and developed in the future. Finally, prevention must have a primary role in mFD treatment, raising awareness around it and, possibly, avoiding its development.

Theta and alpha oscillations may underlie improved attention and working memory in musically trained children.

INTRODUCTION: Attention and working memory are key cognitive functions that allow us to select and maintain information in our mind for a short time, being essential for our daily life and, in particular, for learning and academic performance. It has been shown that musical training can improve working memory performance, but it is still unclear if and how the neural mechanisms of working memory and particularly attention are implicated in this process. In this work, we aimed to identify the oscillatory signature of bimodal attention and working memory that contributes to improved working memory in musically trained children. MATERIALS AND METHODS: We recruited children with and without musical training and asked them to complete a bimodal (auditory/visual) attention and working memory task, whereas their brain activity was measured using electroencephalography. Behavioral, time-frequency, and source reconstruction analyses were made. RESULTS: Results showed that, overall, musically trained children performed better on the task than children without musical training. When comparing musically trained children with children without musical training, we found modulations in the alpha band pre-stimuli onset and the beginning of stimuli onset in the frontal and parietal regions. These correlated with correct responses to the attended modality. Moreover, during the end phase of stimuli presentation, we found modulations correlating with correct responses independent of attention condition in the theta and alpha bands, in the left frontal and right parietal regions. CONCLUSIONS: These results suggest that musically trained children have improved neuronal mechanisms for both attention allocation and memory encoding. Our results can be important for developing interventions for people with attention and working memory difficulties.

Design and Evaluation of a Collective Preventive Program for Musical Performance Anxiety (ConfiDance).

Musical performance anxiety (MPA) is considered a subtype of social phobia and affects musicians who must face musical exposure in public, potentially severely affecting their emotional stability and significantly impairing the quality of their performance. This research has utilized previous scientific knowledge on the issue and a qualitative approach to musicians' needs through focus groups in order to design a collective preventive program for MPA that could be implemented within the training curriculum of professional musicians. To evaluate the adequacy of the preventive program 'ConfiDance', a pilot test was conducted with a sample of 17 professional musicians in training, all post-graduate students in classical music performance. For the pilot test, a quasi-experimental model with a repeated measures methodology (pre-post and one-year follow-up after application) was carried out. The results indicate a significant decrease in MPA after the program implementation, with a notable improvement in effect one year post-application, demonstrating an even greater positive impact over time. These data should be interpreted cautiously due to sample limitations but represent an opportunity for the future implementation of a program that can prevent and treat MPA in music education centers.

Epidemiology of neuromuscular injuries in guitar players living in Portugal: Associated risk factors.

BACKGROUND: Playing guitar involves several physical demands, most inclusive of which are long hours of practice, which can make musculoskeletal symptoms common. OBJETIVE: To determine the epidemiology of neuromuscular injuries in guitar players residing in Portugal and risk factors. METHODS: The sample consisted of 105 guitar players, being 103 (98.10%) men, aged between 30-75 years (29,83±10,23). The measurement instrument used was a digital survey, shared by email, on social networks and in person. RESULTS: Fifty-six (53.30%) guitar players had injuries throughout their musical practice, totaling 132 injuries, 13 (12.40%) guitar players were injured at the time of assessment and 31 (29.5%) guitar players had injuries in the last 12 months, totaling 63 injuries. The value of injury proportion was 0.29 (CI 95% : 0.14-0.44) and the injury rate was 0.42 injuries per 1,000 hours of music practice. The most common types of injury were: tendinopathy (22; 34.92%) and low back pain (9; 14.29%). The most affected anatomical sites were: wrist (18; 28.57%) and lumbar spine (10; 15.87%). Repetitive movement was the injury mechanism most mentioned by guitar players (24; 35.29%) followed by maintaining postures for a prolonged period of time (15; 22.06%). Guitar players who did not warm up before practicing were 0.33 (CI: 0.13-0.79; p = 0.013) more likely to have an injury. CONCLUSIONS: There was a high percentage of injuries in guitar players and failure to warm up was a risk factor for the development of injuries. This type of study can help in creating injury prevention strategies in this type of population.

Performance-related Pain and Disability among Music Students Versus Professional Musicians: a Multicenter Study using a Validated Tool.

OBJECTIVE: To evaluate prevalence of performance-related pain among musicians and compare pain characteristics, associated disability and approach to pain management, between music students and professional musicians. METHODS: A multicenter cross-sectional study was performed in a multi-stage stratified cluster random sample of 585 musicians, stratified by music students (294, among which 234 were at pre-university level and 60 at university level) and professional musicians (291). The main outcome was performance-related pain, measured by Performance-related Pain among Musicians Questionnaire (PPAM). Secondary outcomes were: pain management approach, physical activity levels, fatigue, distress, and health-related quality of life. RESULTS: The lifetime prevalence of performance-related pain was 55.0% (n = 322), being significantly higher among professionals (57.5% versus 42.5%, p < 0.001). Pain intensity scores were significantly higher in professional musicians (p < 0,05), but pain interference in performance was higher among music students, who also reported significantly higher levels of fatigue (p = 0.008) and distress (p < 0.001), and lower quality of life (p < 0.001). Regardless of the high levels of pain intensity and interference, fatigue, anxiety and depression, and low levels of quality of life, 33% musicians who developed pain had never looked for healthcare (this proportion is significantly higher for music students, 57%, p < 0.001). CONCLUSIONS: We present the first multicenter study on performance-related pain among musicians with different backgrounds, using a validated tool, and distinguishing music students from professional musicians. Performance-related pain is a highly prevalent and disabling condition among musicians, however, its proper evaluation and management are still often underappreciated, contributing to significant impairments and reduced quality of life.

Music facilitation styles and behaviours across the health-care continuum: explanatory multiple case studies.

BACKGROUND: Understanding how music group facilitators work across the health-care continuum has received sparse research attention. METHODS: An explanatory multiple case study design was used to identify approaches employed by experienced facilitators. Five music facilitators working in contrasting areas of practice were interviewed and video recorded engaging with the same groups at three timepoints. RESULTS: All facilitators demonstrated four common behaviours: applying a consistent structure for each session; creating a positive and relaxing atmosphere for the work; engaging with varying musical repertoire and activities; and offering clear instructions for the participants. Their styles of practice were found to be shaped by their personality, educational background, as well as the size of the group, health conditions, and cultural identities of their music participants. CONCLUSION: These skilled facilitators showed flexibility, always aiming to accommodate participants' needs, and revealing new evidence of a common approach to music facilitation across different types of participant groups.

Questionnaire for Orchestra Musicians: Validation of the Online Version of the Musculoskeletal Pain Intensity and Interference Questionnaire for Polish Musicians (MPIIQM-P).

Background: The only complete and validated tool for evaluating professional orchestra musicians is the English-language Musculoskeletal Pain Intensity and Interference Questionnaire for professional orchestra Musicians (MPIIQM) questionnaire, which, in recent years, has been translated, adapted, and validated in other languages. The aim of the study was to validate the online version of the Polish version of the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM-P). Materials and Methods: The group included 182 professional musicians. The respondents were asked to complete the MPIIQM-P, BPI, and QuickDash questionnaires twice within an interval of 4 days. The questionnaires were created in the web form creator-Google Form. Results: The EFA analysis showed a two-factor structure of the questionnaire consisting of factor 1-pain intensity and factor 2-pain interference. The internal agreement of the factors identified in the EFA analysis was measured by the α Cronbach index reaching from 0.813 to 0.913. The intraclass correlation coefficient of both factors ranged from 0.276 to 0.583. The analysis of convergent and divergent validity between the subscales of the questionnaire value ranged from 0.414 to 0.925. Conclusions: The online version of the MPIIQM-P questionnaire is a valid and reliable tool for the assessment of musculoskeletal pain and interference. The online MPIIQM-P questionnaire maintains the psychometric properties previously defined for the paper version.

Metacognition in musical practices: two studies with beginner and expert Brazilian musicians.

Metacognition is essential in the musical learning process as it involves understanding the purpose of each task, its planning, execution and evaluation. Considering the relevance of metacognitive processes, our objective in this study was to investigate how expert and beginner musicians manifest and verbalize their metacognitive processes in the context of preparing repertoire for a performance. The method used was a multi-case study carried out in two different contexts: with the five members of a brass quintet made up of professional musicians and with three beginner university violin students. The results obtained indicated that even at different levels of expertise, metacognitive processes were present in the musical practices of participants in the two contexts investigated. It was found that in both cases time management is a component of the preparation process in metacognitive regulation, however, for the beginner violinists in our sample it was a significantly more complex task than for the professional brass players. Regarding the learning monitoring and evaluation processes, it was possible to verify that beginner instrumentalists as well as professional musicians used declarative, conditional and procedural knowledge to carry out and reflect on their musical practices. These results have implications for both the individual and collective study process and for teaching processes. It is also observed that reflective thinking must accompany the processes of individual and collective interpretative-musical practices, considering that the musical results desired by musicians are related to the quality of cognitive, behavioral, affective and motivational undertakings pertinent to control and regulation of metacognitive processes.

Is intraoperative mapping of music performance mandatory to preserve skills in professional musicians? Awake surgery for lower-grade glioma conducted from a meta-networking perspective.

OBJECTIVE: In surgery for lower-grade glioma (LGG) in professional musicians, for whom preserving music ability is essential, a critical question has emerged, namely, is it mandatory to include music performance during awake mapping, as proposed in several reports? In fact, music ability is subserved by a mosaic of interactive cognitive and emotional processes that rest on several networks. Therefore, from a meta-network perspective, the authors investigated whether an integrated multimodal monitoring of these cognitive and emotional functions during stimulation mapping could be efficient in maintaining musical skill. Indeed, it could be difficult for a patient to play a musical instrument in the surgical setting in addition to performing other tasks, such as movement and language. METHODS: An awake mapping-guided resection for LGG without intraoperative music performance was performed in 3 professional musicians. Intraoperative tests were tailored to each patient depending on the critical corticosubcortical circuits surrounding the tumor, including not only sensorimotor or language skills but also higher-order functions with a constant multitasking during the resection. RESULTS: Although music skills were not mapped during surgery, all patients resumed their professional activities, preserving the ability to play music and to perform concerts, to teach and to compose music, or to start learning a new instrument. CONCLUSIONS: A connectome-based resection without intraoperative music performance seems effective in achieving maximal glioma removal while preserving crucial networks subserving musical skills, creativity, and music learning. Neurosurgery should evolve toward a meta-networking approach to better understand higher-order functions mediating complex behavior, such as being a professional musician.

Warm-up exercises reduce music conservatoire students' pain intensity when controlling for mood, sleep and physical activity: A pilot study.

Introduction: Playing-related musculoskeletal pain is highly prevalent among classical music students, affecting them physically and psychologically. Unlike athletes or dancers, musicians' pain often goes untreated due to stigma and lack of specialised healthcare. While warm-up exercises are common practice in sports and dance, there is a lack of empirical research regarding physical warm-ups for musicians' pain. This study aimed to investigate the effects of a 2-week daily warm-up exercise intervention on conservatoire students' pain intensity, interference and psychological distress, at day 0 and after 2 weeks. Methods: Two groups were considered: an exercise (n = 9) and a waitlist control (n = 7) group. Data were collected using online Qualtrics surveys at three different stages. Results: 2 × 2 mixed ANOVAs indicated no significant effects on any of the outcome variables. However, when controlling for sleep, anxiety, depression and physical activity, the analyses revealed a significantly greater decrease in pain intensity in the exercise group compared to the control. In addition, bivariate correlations indicated that pain interference, anxiety and depression delta scores were significantly correlated for the exercise but not the control group. Anxiety and pain intensity delta scores were significantly correlated in both groups. Conclusions: These findings suggest that daily warm-up exercises have the potential to reduce musicians' pain intensity but only if certain variables are factored in. This pilot study highlights the multifactorial nature of musicians' pain and unveils the role that mood, sleep and physical activity level may have when assessing the efficacy of interventions based on warm-up exercises.

Attitudes in music practice: a survey exploring the self-regulated learning processes of advanced Brazilian and Portuguese musicians.

Introduction: This study aimed to investigate the Self-Regulated Learning behaviors of advanced Brazilian and Portuguese musicians and how these processes vary in terms of gender, nationality, musical instrument, quantity of practice, expertise, and professional experience. Methods: 300 participants fully completed the 22-item questionnaire "Attitudes in music practice". The sample comprised of 54.3% males, 44.0% females, and 1% non-binary; 0.7% did not respond. 68.0% (n = 204) were Brazilian, and 32.0% (n = 96) were Portuguese. The mean age was 32.70 years old (SD = 11.261), the mode was 22 years old, with a range of 18 to 66 years. Data analysis procedure included exploratory factor analysis, internal consistency, independent sample t test, analysis of variance (ANOVA), and chi-square tests. Results: Exploratory Factor Analysis generated three factors: Practice Organization, Personal Resources, and External Resources. The results report there are no differences in SRL scores in terms of gender, nationality, and musical instrument. However, One-way ANOVA test results convey differences in SRL scores and the quantity of practice and expertise with those musicians who reported practicing for longer periods scoring more highly than participants who declared spending less time on daily practice. Discussion: The results for the expertise variables suggest that more experienced and older musicians scored higher in Personal Resources and lower in External Resources indicating that, as musicians gain in experience, their metacognitive processes become more evident than the social factors of their performance.

Music literacy improves reading skills via bilateral orthographic development.

Considerable evidence suggests that musical education induces structural and functional neuroplasticity in the brain. This study aimed to explore the potential impact of such changes on word-reading proficiency. We investigated whether musical training promotes the development of uncharted orthographic regions in the right hemisphere leading to better reading abilities. A total of 60 healthy, right-handed culturally matched professional musicians and controls took part in this research. They were categorised as normo-typical readers based on their reading speed (syl/sec) and subdivided into two groups of relatively good and poor readers. High density EEG/ERPs were recorded while participants engaged in a note or letter detection task. Musicians were more fluent in word, non-word and text reading tests, and faster in detecting both notes and words. They also exhibited greater N170 and P300 responses, and target-non target differences for words than controls. Similarly, good readers showed larger N170 and P300 responses than poor readers. Increased reading skills were associated to a bilateral activation of the occipito/temporal cortex, during music and word reading. Source reconstruction also showed a reduced activation of the left fusiform gyrus, and of areas devoted to attentional/ocular shifting in poor vs. good readers, and in controls vs. musicians. Data suggest that music literacy acquired early in time can shape reading circuits by promoting the specialization of a right-sided reading area, whose activity was here associated with enhanced reading proficiency. In conclusion, music literacy induces measurable neuroplastic changes in the left and right OT cortex responsible for improved word reading ability.