Probing the neural dynamics of musicians' and non-musicians' consonant/dissonant perception: Joint analyses of electrical encephalogram (EEG) and functional magnetic resonance imaging (fMRI).

The perception of two (or more) simultaneous musical notes, depending on their pitch interval(s), could be broadly categorized as consonant or dissonant. Previous literature has suggested that musicians and non-musicians adopt different strategies when discerning music intervals: while musicians rely on the frequency ratios between the two fundamental frequencies, such as "perfect fifth" (3:2) as consonant and "tritone" (45:32) as dissonant intervals; non-musicians may rely on the presence of 'roughness' or 'beats', generated by the difference of fundamental frequencies, as the key elements of 'dissonance'. The separate Event-Related Potential (ERP) differences in N1 and P2 along the midline electrodes provided evidence congruent with such 'separate reliances'. To replicate and to extend, in this study we reran the previous experiment, and separately collected fMRI data of the same protocol (with sparse sampling modifications). The behavioral and EEG results largely corresponded to our previous finding. The fMRI results, with the joint analyses by univariate, psycho-physiological interaction, and representational similarity analysis (RSA) approaches, further reinforce the involvement of central midline-related brain regions, such as ventromedial prefrontal and dorsal anterior cingulate cortex, in consonant/dissonance judgments. The final spatiotemporal searchlight RSA provided convincing evidence that the medial prefrontal cortex, along with the bilateral superior temporal cortex, is the joint locus of midline N1 and dorsal anterior cingulate cortex for the P2 effect (for musicians). Together, these analyses reaffirm that musicians rely more on experience-driven knowledge for consonance/dissonance perception; but also demonstrate the advantages of multiple analyses in constraining the findings from both EEG and fMRI.

Live music in the intensive care unit-A mixed-methods pilot study exploring the experience and impact of live music played for the adult intensive care patient.

BACKGROUND: Evidence for music's beneficial effect on physical and mental disorders is mounting. Intensive care unit (ICU) patients experience multiple uncomfortable symptoms, which may be alleviated using a music-based intervention. Few studies have examined the experience and the physical impact of patient-tailored live music offered by trained health musicians in an adult ICU. AIMS: This study aimed to explore the experience of live music in adult patients admitted to an ICU, focusing on its effects on relaxation, stress, and pain. STUDY DESIGN: A pilot study with a convergent mixed-methods design. A total of 27 intensive care patients at a Danish University Hospital were offered patient-tailored live music by trained musicians in a single-session design. We performed participant observation and conducted patient interviews using an observational and semistructured interview guide. These data were supported by quantitative pre-post measurements of heart rate, respiration rate, mean arterial blood pressure, subjective pain experience, and heart-rate variability. The study was conducted from February 2020 to December 2021. FINDINGS: Using a Ricoeur-inspired analysis of observations and interviews, we elicited four themes: 'A break where you can swim away and relax', 'The living presence makes the play unique', 'Happy memories of the past and longing for home', and 'An intense and meaningful experience'. The quantitative analysis showed a significant decrease in heart rate (4.33 bpm, p < 0.02), respiration rate (2.93, p < 0.001), and blood pressure (3.30, p < 0.05) and a significant increase in heart-rate variation (-0.22, p < 0.01). Seven patients reported pain reduction after the music intervention, corresponding to a 24% reduction. CONCLUSION: Live music contributes to meaningful moments by bringing elements of everyday life into the ICU and may promote relaxation and reduce stress and pain. RELEVANCE TO CLINICAL PRACTICE: Our findings indicate that live music is a nonpharmacological experience that creates meaningful moments for critically ill patients.

Allergic contact dermatitis to woods of the genus Dalbergia in musical instruments.

BACKGROUND: The woods of trees of the genus Dalbergia are a frequent cause of allergic contact dermatitis. OBJECTIVES: To describe the different patterns of symptoms and sensitisation to woods of the genus Dalbergia in four patients whose regular work is linked to music, either as performers (two patients) or instrument makers. RESULTS: The patients showed extensive cross-reactivity between the different Dalbergia woods. The two musicians exhibited symptoms exclusively in the contact areas, while the instrument makers showed a pattern of airborne symptoms. The period from sensitisation to the development of symptoms varied greatly among the patients. CONCLUSIONS: The symptoms of allergic contact dermatitis to Dalbergia woods differ markedly depending on the route of contact. Cross-reactivity between the woods of this genus is very wide. The sensitising potential varies between the various Dalbergia woods, which require different contact periods depending on their sensitising power.

Peripheral nerve injuries in the performing artist.

Dancers and musicians have unique physical demands that can lead to injury of the peripheral nerves. Specific dance movements and specific instrument positions, combined with countless hours of practice and repetition, create an environment for potential nerve injury. Familiarity with these variables and recognition of the common presentations of neuropathic syndromes are essential in the evaluation of a performing artist with a suspected peripheral nerve injury. Assessment should include an understanding and analysis of their dance style or instrument playing posture, particularly in the position or motion that recreates the symptoms if possible. Practice and performance schedules should also be considered. Diagnosis may require electrodiagnostic testing, imaging, or diagnostic injections. Treatment should be comprehensive and may include modifications in practice schedule, posture/position, and technique in addition to consideration of medications, splints/orthoses, physical therapy, and injections. The instructor/teacher should be involved in the treatment plan if applicable. Complete rest in this population may not be realistic or necessary. Early and accurate diagnosis of nerve injury is important for safe return to dance or instrumental music.

Incobotulinum Toxin-A in Professional Musicians with Focal Task-Specific Dystonia: A Double Blind, Placebo Controlled, Cross-Over Study.

Background: Musician's focal task-specific dystonia is a complex disorder of fine motor control, with incomplete understanding of its etiology. There have been relatively few trials of botulinum toxin in upper limb task-specific dystonia, and prior studies have yielded variable results, leading to skepticism regarding the utility of this approach in elite performers. Methods: We conducted a double-blind, placebo-controlled, randomized, cross-over study of incobotulinum toxin-A in 21 professional musicians with focal upper extremity task-specific dystonia affecting performance on their instrument, using a novel paradigm of initial injections followed by booster injections at two- and four-week intervals. The primary outcome measure was the change in blinded dystonia rating of the active arm by two expert raters using a Clinical Global Impression numeric scale at week 8 compared to enrollment. Findings: 19 men and 2 women with musicians' dystonia were enrolled over a six-year period. Nineteen patients completed the study. Analysis of the primary outcome measure in comparison to baseline revealed a change in dystonia severity of P = 0.04 and an improvement in overall musical performance of P = 0.027. No clinically significant weakness was observed, and neutralizing antibodies to toxin were not found. Interpretation: Despite its small sample size, our study demonstrated a statistically significant benefit of incobotulinum toxin-A injections as a treatment for musicians' task-specific dystonia. Tailoring the use of toxin with booster injections allowed refinement of dosing strategy and outcomes, with benefits that were meaningful to patients clearly visible on videotaped evaluations. In addition to its application to musicians' dystonia, this approach may have relevance to optimize application of botulinum toxin in other forms of focal dystonia such as blepharospasm, cervical dystonia, writer's cramp, and spasmodic dysphonia.

Video-based diagnosis support system for pianists with Musician's dystonia.

Background: Musician's dystonia is a task-specific movement disorder that deteriorates fine motor control of skilled movements in musical performance. Although this disorder threatens professional careers, its diagnosis is challenging for clinicians who have no specialized knowledge of musical performance. Objectives: To support diagnostic evaluation, the present study proposes a novel approach using a machine learning-based algorithm to identify the symptomatic movements of Musician's dystonia. Methods: We propose an algorithm that identifies the dystonic movements using the anomaly detection method with an autoencoder trained with the hand kinematics of healthy pianists. A unique feature of the algorithm is that it requires only the video image of the hand, which can be derived by a commercially available camera. We also measured the hand biomechanical functions to assess the contribution of peripheral factors and improve the identification of dystonic symptoms. Results: The proposed algorithm successfully identified Musician's dystonia with an accuracy and specificity of 90% based only on video footages of the hands. In addition, we identified the degradation of biomechanical functions involved in controlling multiple fingers, which is not specific to musical performance. By contrast, there were no dystonia-specific malfunctions of hand biomechanics, including the strength and agility of individual digits. Conclusion: These findings demonstrate the effectiveness of the present technique in aiding in the accurate diagnosis of Musician's dystonia.

Efficacy and safety of zolpidem for musician's dystonia.

Background: The efficacy and safety of zolpidem in treating musician's dystonia are not well understood. Objective: We aimed to retrospectively investigate the efficacy and safety of zolpidem for musician's dystonia. Methods: We retrospectively reviewed medical records between January 2021 and December 2023 to identify patients with musician's dystonia who had been prescribed zolpidem. The Tubiana's musician's dystonia rating scale (range, 1-5; lower scores indicating greater severity) was used to evaluate musician's dystonia. Results: Fifteen patients were included in this study. The mean effective dose of zolpidem was 5.3±2.0 mg. The mean effective duration of zolpidem was 4.3±1.2 h. With zolpidem administration, the Tubiana's musician's dystonia rating scale score significantly improved from 2.2±1.0 to 4.3±0.8 (48.9% improvement, p<0.001). Two patients (13.3%) discontinued the drug owing to unsatisfactory results or sleepiness. Conclusion: This study suggests that zolpidem may be an alternative treatment option for musician's dystonia.

Off the Beats and Track: Finding Historical Lesbian and Queer Women's Feminist Spaces through Musicians' Tour Schedules, Concert Flyers, and Correspondence.

This article explores historical research methods used to locate lesbians and queer women, especially within American and Canadian contexts from the 1960s onward. It begins by discussing methods such as analyzing women's and lesbian travel guides, directories, maps, periodicals, newsletters, newspapers, websites, oral histories, social media, archival fonds and collections. In particular, this article explores how utilizing lesbian and queer women musicians' tour schedules, calendars, correspondence, and contracts for shows and appearances can be a valuable historical research method, especially for locating impermanent historical lesbian and queer women's spaces off the beaten track. The article focuses on the Alix Dobkin Papers as a case study to explore aspects of historical lesbian and queer women's spaces and demonstrate the utility of this historical research method beyond Dobkin. The papers of Alix Dobkin include business correspondence, fan mail, fliers and programs from concerts, subject files, t-shirts, photographs, and memorabilia. As Dobkin played an important role in the women's music movement and toured regularly, her papers provide useful insight into historical debates about lesbian anti-racist politics, ethical consumption, community organizing, and transgender inclusion and exclusion.

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.

Zolpidem improves task-specific dystonia: A randomized clinical trial integrating exploratory transcranial magnetic stimulation and [18F] FDG-PET imaging.

BACKGROUND: Task-specific dystonia (TSFD) is a disabling movement disorder. Effective treatment options are currently limited. Zolpidem was reported to improve primary focal and generalized dystonia in a proportion of patients. The mechanisms underlying its therapeutic effects have not yet been investigated. METHODS: We conducted a randomized, double-blind, placebo-controlled, crossover trial of single-dose zolpidem in 24 patients with TSFD. Patients were clinically assessed using Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS), Writers' Cramp Rating Scale (WCRS), and Visual Analogue Scale (VAS), before and after receiving placebo and zolpidem. Transcranial magnetic stimulation was conducted on placebo and zolpidem to compare corticospinal excitability - active and resting motor thresholds (AMT and RMT), resting and active input/output curves and intracortical excitability - cortical silent period (CSP), short-interval intracortical inhibition curve (SICI), long-interval intracortical inhibition (LICI) and intracortical facilitation (ICF). Eight patients underwent brain FDG-PET imaging on zolpidem and placebo. RESULTS: Zolpidem treatment improved TSFD. Zolpidem compared to placebo flattened rest and active input/output curves, reduced ICF and was associated with hypometabolism in the right cerebellum and hypermetabolism in the left inferior parietal lobule and left cingulum. Correlations were found between changes in dystonia severity on WCRS and changes in active input/output curve and in brain metabolism, respectively. Patients with lower RMT, and higher rest and active input/output curves exhibited better response to zolpidem compared to placebo. CONCLUSIONS: Zolpidem improved TSFD by reducing corticomotor output and influencing crucial nodes in higher-order sensory and motor networks.

Gender Differences in Task Specific Dystonia: What Can we Learn from Musician's Dystonia?

BACKGROUND: Musician's Dystonia (MD) is a task specific, focal dystonia which usually occurs only at the instrument. The pathophysiology is not fully understood, but several risk factors like over-practice and genetic predisposition are known. Interestingly, 80% of those affected are men, which stands in contrast to the gender distribution in other focal dystonias, such as cervical dystonia. OBJECTIVES: Our aim was to evaluate the difference in women and men with regard to risk factors leading to MD. METHODS: We investigated known risk factors for MD in a large cohort of 364 MD patients by retrospectively collecting data on practice behavior and family history. RESULTS: In line with previous studies, we found a ratio of ~4:1 men to women. Age at onset of MD was significantly lower in women; however, subsequent analysis revealed that it was a positive family history (FH+) and not gender that was associated with a lower age at onset. Furthermore, we found that those with negative family history had accumulated more practice time until onset of MD. CONCLUSIONS: These results imply that the earlier age at onset in women did not depend on gender but was due to the higher proportion of a positive family history. In contrast, men were less likely to have a positive family history, suggesting that genetic factors may not be the primary reason for the higher prevalence of MD in men. Instead, differences in practice behaviors between men and women may contribute to this gender disparity.

Factors associated with psychological distress of workers in the Finnish Evangelical Lutheran Church.

BACKGROUND: The work of church employees contains many elements causing symptoms of stress and anxiety. They can lead into psychological distress and possibly indicate the beginning of a more serious psychological state. Women seem to be more disposed to psychological stress than men. We investigated factors contributing to psychological distress among women and men in four professions of the Evangelical Lutheran Church of Finland (ELCF). METHODS: A link to an electronic survey was sent to the members of respective trade unions of four professions of the ELCF, and we got responses from pastors (n = 241), church musicians (n = 92), diaconal workers (n = 85) and youth workers (n = 56). Psychological distress was assessed using the Mental Health Inventory-5 (MHI-5; cut-off value ≤ 52 indicating severe distress). We used logistic regression to examine sociodemographic, health-related, and work-related factors that could potentially be associated with psychological distress. RESULTS: We found severe psychological distress in all profession groups. Gender differences were scarce. Loneliness was the most important factor associated with psychological distress in both men and women (OR 14.01; 95% CI 2.68-73.25 and OR 7.84; 3.44-17.88, respectively), and among pastors and church musicians (OR 8.10; 2.83-23.16 and OR 24.36; 2.78-213.72, respectively). High mental strain of work was associated with distress in women (OR 2.45; 1.01-5.97). Good work satisfaction was a protective factor for men and women (OR 0.06; 95% CI 0.01-0.40 and OR 0.61; 0.18-0.40, respectively) and for pastors and church musicians (OR 0.22; 0.08-0.73 and OR 0.06; 0.01-0.43, respectively). For women, additional protective factors were being a pastor (OR 0.26; 0.07-0.95), or youth worker (OR 0.08; 0.01-0.48), and good self-reported health (OR 0.38; 0.18-0.82). CONCLUSION: Even though we found some protective factors, the share of workers with severe distress was higher in all profession groups of the ELCF than in the general population. Loneliness was the strongest stressor among both genders and high mental strain among women. The result may reflect unconscious mental strain or subordination to the prevailing working conditions. More attention should be paid to the mental wellbeing and work conditions of church employees.

Musical experience influences socio-emotional functioning in behavioural variant frontotemporal dementia.

Objectives: On phenotypic and neuroanatomical grounds, music exposure might potentially affect the clinical expression of behavioural variant frontotemporal dementia (bvFTD). However, this has not been clarified. Methods: 14 consecutive patients with bvFTD fulfilling consensus diagnostic criteria were recruited via a specialist cognitive clinic. Earlier life musical experience, current musical listening habits and general socio-emotional behaviours were scored using a bespoke semi-quantitative musical survey and standardised functional scales, completed with the assistance of patients' primary caregivers. Associations of musical scores with behavioural scales were assessed using a linear regression model adjusted for age, sex, educational attainment and level of executive and general cognitive impairment. Results: Greater earlier life musical experience was associated with significantly lower Cambridge Behavioural Inventory (Revised) scores (ß ± SE = -17.2 ± 5.2; p = 0.01) and higher Modified Interpersonal Reactivity Index (MIRI) perspective-taking scores (ß ± SE = 2.8 ± 1.1; p = 0.03), after adjusting for general cognitive ability. Number of hours each week currently spent listening to music was associated with higher MIRI empathic concern (ß ± SE = 0.7 ± 0.21; p = 0.015) and MIRI total scores (ß ± SE = 1.1 ± 0.34; p = 0.014). Discussion: Musical experience in earlier life and potentially ongoing regular music listening may ameliorate socio-emotional functioning in bvFTD. Future work in larger cohorts is required to substantiate the robustness of this association, establish its mechanism and evaluate its clinical potential.

Musical training is not associated with spectral context effects in instrument sound categorization.

Musicians display a variety of auditory perceptual benefits relative to people with little or no musical training; these benefits are collectively referred to as the "musician advantage." Importantly, musicians consistently outperform nonmusicians for tasks relating to pitch, but there are mixed reports as to musicians outperforming nonmusicians for timbre-related tasks. Due to their experience manipulating the timbre of their instrument or voice in performance, we hypothesized that musicians would be more sensitive to acoustic context effects stemming from the spectral changes in timbre across a musical context passage (played by a string quintet then filtered) and a target instrument sound (French horn or tenor saxophone; Experiment 1). Additionally, we investigated the role of a musician's primary instrument of instruction by recruiting French horn and tenor saxophone players to also complete this task (Experiment 2). Consistent with the musician advantage literature, musicians exhibited superior pitch discrimination to nonmusicians. Contrary to our main hypothesis, there was no difference between musicians and nonmusicians in how spectral context effects shaped instrument sound categorization. Thus, musicians may only outperform nonmusicians for some auditory skills relevant to music (e.g., pitch perception) but not others (e.g., timbre perception via spectral differences).

An overview of rehabilitation approaches for focal hand dystonia in musicians: A scoping review.

OBJECTIVE: To provide a comprehensive overview of rehabilitation treatment strategies for focal hand dystonia (FHD) in musicians, examining their evolution and effectiveness. DATA SOURCES: A systematic search of five databases, PubMed, PEDro, Cochrane Library, Trip, and Google Scholar, to identify relevant articles on FHD rehabilitation. The last search was performed on 20 December 2023. METHODS: Inclusion criteria were applied to 190 initially identified articles, resulting in 17 articles for review. Exclusions were made for duplicates, irrelevant titles, abstracts, and non-rehabilitation interventions. RESULTS: Ten different rehabilitation approaches were identified over 20 years. While no definitive intervention protocol exists, a multimodal approach is commonly recommended. CONCLUSIONS: This scoping review underscores the diversity of rehabilitation strategies for FHD. It suggests the potential of multimodal approaches, emphasizing the need for further large-scale clinical efficacy studies.

Muscle fatigue during assisted violin performance.

Muscle fatigue is a primary risk factor in developing musculoskeletal disorders, which affect up to 93% musicians, especially violinists. Devices providing dynamic assistive support (DAS) to the violin-holding arm can lessen fatigue. The objective was to assess DAS effects on electromyography median frequency and joint kinematics during a fatiguing violin-playing task. Fifteen university-level and professional violinists were equipped with electromyography sensors and reflective markers to record upper-body muscle activity and kinematics. They played G scales with and without DAS until exhaustion. Paired t-tests assessed DAS effects on delta (final-initial) electromyography median frequencies and joint kinematics. DAS prevented the median frequency decrease of left supraspinatus, superior trapezius, and right medial deltoid, and increases in trunk rotation, left-wrist abduction, and right arm-elevation plane. DAS effects on kinematics were marginal due to retention of musical performance despite fatigue. However, DAS reduced fatigue of several muscles, which is promising for injury prevention.Practitioner summary: Violinists are greatly affected by musculoskeletal disorders. Effects of a mobility assistive device on muscle fatigue during violin playing was investigated. The assistive technology slowed down the development of fatigue for three neck/shoulder muscles, making assisted musical performance a promising avenue to prevent violinists' injuries.

Relationship between playing-related factors and occupational balance in professional violinists.

BACKGROUND: Playing performance of musicians may affect their occupational balance. The violin is one of the riskiest string instruments for the musculoskeletal health. OBJECTIVE: To show the effect of socio-demographics, playing posture, pain, and functionality on occupational balance in professional violinists in Istanbul. METHODS: Forty-five violinists aged 29.1±10.6 years were included. The Personal Information Form, the Edinburgh Handedness Inventory, the Wong-Baker Faces Pain Rating Scale, the Disability of Arm, Shoulder and Hand - Sports/Musicians (DASH-SM), the Rapid Upper Limb Assessment, and the 11-item revised version of the Occupational Balance Questionnaire (OBQ11 - T) were used. Spearman correlation analysis was performed to examine the relationship between the variables and occupational balance. RESULTS: The only significant correlation was found between doing regular exercise and occupational balance (r = 0.539, p < 0.001) with those having an exercise habit reporting higher occupational balance scores. The mean pain score of the violinists increased from a pre-performing mean of 1.6±2.3 to a post-performance mean of 3.91±2.4. CONCLUSIONS: Musicians indicate that they practice physical exercise regularly. A strong methodological limitation of this study is that variables like exercise were evaluated with a self-reported survey which limited the analysis and so we hardly find any relationships between them. To the best of our knowledge, this is the first study to evaluate the relationship between playing-related factors and occupational balance in violinists. There may be other factors affecting occupational balance in violinists and also in the other musicians. Similar studies are needed in other countries also using different assessments specific to musicians.

Interviews with musicians with hearing aids.

Objectives: Musicians who wear hearing aids are a unique subset of hearing-impaired individuals. There are a number of issues musicians experience with hearing aids, making effective hearing rehabilitation a challenge. Research suggests hearing aid satisfaction in musicians is lower partly due to their advanced listening skills, however, qualitative research addressing musicians who wear hearing aids for music is scarce. The current study aimed to record the barriers encountered by musicians who wear hearing aids when playing their instrument/singing, listening to recorded music and listening to live music.Design: Professional musicians who wear hearing aids were interviewed. Participants were questioned about their experiences with hearing loss and hearing aids, with particular emphasis on experiences listening to recorded and live music, and playing or performing music with the hearing aids.Study Sample: Eight professional musicians were interviewed, using a semi-structured interview style, with a question and prompt guide.Results: Thematic analysis revealed three main themes in the data: the musicians' journey, communication, and flexibility/adjustability.Conclusions: The results have implications for future research into specific fitting parameters for hearing aids for musicians (particularly for music performance), the need for evidence-based rehabilitation programs for musicians with hearing loss, and the need for a glossary of terms to assist communication between Audiologists and musicians.