ABSTRACT
BACKGROUND: Musicians' dystonia (MD) is a movement disorder with several established risk factors, but the exact pathophysiology remains unknown. Recent research suggests dysfunction in sensory-motor, basal ganglia, cerebellar, and limbic loops as potential causes. Adverse childhood experiences are also considered risk factors. OBJECTIVE: This study aimed to investigate whether MD patients have experienced more childhood trauma, leading to increased stress reactivity and neural vulnerability to movement disorders. METHODS: Using functional magnetic resonance imaging and the Montreal Imaging Stress Task, 40 MD patients were compared with 39 healthy musicians (HMs). Whole-brain analysis and regions of interest analysis were performed. Parameter estimates and subjective stress levels were compared between groups and correlated with the Childhood Trauma Questionnaire. RESULTS: MD patients reported significantly higher childhood trauma scores than healthy control subjects, but they did not differ in their subjective stress experiences. Stress-related activity of limbic areas was neither found in the whole sample nor between the two groups. Instead, increased activity of visual association and temporal areas was observed, but this activation did not differ between patients and HMs. However, patients showed a tendency toward reduced precuneus activity under stress. Adverse childhood experiences were negatively correlated with precuneus, thalamus, and substantia nigra activity across all participants. CONCLUSIONS: Overall, MD patients and HMs had similar subjective and neurological reactions to stress but differed in childhood trauma experiences and precuneus activity under stress. Further research about the functional connectivity between precuneus, cerebellum, thalamus, and basal ganglia in musicians is needed. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
ABSTRACT
OBJECTIVES: Perfection is a central goal for many musicians and health professionals. The present study compared perfectionism between music and medical students to examine whether perfectionism is adaptive or maladaptive and how it evolves during university studies. Furthermore, the association between perfectionism and anxiety was investigated in both populations to determine possible implications for mental and general health. METHODS: 110 music students (61 F, avg age 23.2 yrs) and 281 medical students (209 F, avg age 23.3 yrs) took part in the study. Perfectionism was surveyed using two multidimensional perfectionism scales and anxiety was measured using the State-Trait-Anxiety-Inventory. Subscales and total scores of the perfectionism scales were compared within and between groups and correlated with the anxiety measures. RESULTS: Music and medical students did not differ in their level of perfectionism. However, music students in the early semesters showed significantly (p = 0.009) stronger maladaptive perfectionism (mean 0.3, SD 1.4) than students from more senior semesters (-0.3, 1.7). Musicians from early semesters also scored higher on "parental expectations and criticism" (p = 0.04), showed more "concerns over mistakes and doubts" (p = 0.009), and perfectionism in general (p = 0.01). Analysis of the anxiety measure showed a strong correlation (rs = 0.55) between maladaptive perfectionism and anxiety for the music students. Semester and age had no influence on anxiety. Maladaptive perfectionism and adaptive perfectionism both correlated significantly with anxiety in medical students. CONCLUSION: Music and medical students had similar levels of perfectionism. Medical students maintained a consistent level of perfectionism throughout their studies, while music students were more perfectionistic at the beginning of their education. For both groups, perfectionism was significantly correlated with anxiety.