Objective: Our objective was to evaluate gender differences of risk factors contributing to the development of Musician’s Dystonia.

Background: Musician’s Dystonia (MD) is a task specific, focal dystonia (FD) which usually only occurs at the instrument. The pathophysiology is not yet fully understood, but several risk factors such as over-practice and genetic predisposition are known. Interestingly, about 80% of those affected by MD are men. This is different than in most other FDs such as blepharospasm and cervical dystonia, which affect more women than men. As in MD, women are less often affected by Writer’s Cramp, but have an earlier age of symptom onset.

Method: We included 364 patients with MD who had filled in a questionnaire in which we assessed epidemiological data, course of the disease, musical education, practice behaviors and family history for neurological diseases. We performed a Wilcoxon or chi-square test for non-normally distributed or categorical data respectively. The significance level was α<0.05.

Results: 21,6 % of our patients with MD were females. The proportion of women with a positive family history for movement disorders was significantly higher (24,4%) compared to men (10,8%). Median age at onset of MD was significantly lower in women than in men (30 vs. 35 years). Female participants began playing their instruments significantly earlier (median age 7(f) vs 9(m) years). Cumulative practice time (CPT) through age 20 was significantly higher in women, while CPT did not differ significantly at age 30.

Conclusion: While men were affected four times more often by MD, surprisingly, proportionally more women had a positive family history. Previous studies showed that a positive family history is associated with an earlier onset of MD, which might explain why the onset of MD was earlier in women. In addition, our findings may indicate that the primary risk factor leading to MD more frequently in men might not be genetic predisposition, but may be related to practice behavior. This seems to include a later start of instrumental playing and a compensation for the lower CPT present at age 20, thus implying a greater increase in daily practice time between ages 20 and 30 in males as compared to females. This is especially interesting as it is known that a late start of instrumental playing and a sudden increase of practice time are risk factors for the onset of MD. More studies are needed to further evaluate these aspects.

References: Altenmüller, & Jabusch. (2010b). Focal dystonia in musicians: Phenomenology, pathophysiology and triggering factors. European Journal of Neurology, 17(s1), 31–36. https://doi.org/10.1111/j.1468-1331.2010.03048.x
Doll-Lee, J., Lee, A., & Haslinger, B. (in preparation). Musician’s Dystonia: Family history as a predictor for onset and course of the disease.
Jabusch, H.-C., Zschucke, D., Schmidt, A., Schuele, S., & Altenmüller, E. (2005). Focal dystonia in musicians: Treatment strategies and long-term outcome in 144 patients. Movement Disorders: Official Journal of the Movement Disorder Society, 20(12), 1623–1626. https://doi.org/10.1002/mds.20631
Jankovic, J., & Ashoori, A. (2008). Movement disorders in musicians. Movement Disorders: Official Journal of the Movement Disorder Society, 23(14), 1957–1965. https://doi.org/10.1002/mds.22255
Roze, E., Soumaré, A., Pironneau, I., Sangla, S., de Cock, V. C., Teixeira, A., Astorquiza, A., Bonnet, C., Bleton, J. P., Vidailhet, M., & Elbaz, A. (2009). Case-control study of writer’s cramp. Brain: A Journal of Neurology, 132(Pt 3), 756–764. https://doi.org/10.1093/brain/awn363
Schmidt, A., Jabusch, H.-C., Altenmüller, E., Hagenah, J., Brüggemann, N., Lohmann, K., Enders, L., Kramer, P. L., Saunders-Pullman, R., Bressman, S. B., Münchau, A., & Klein, C. (2009). Etiology of musician’s dystonia: Familial or environmental? Neurology, 72(14), 1248–1254. https://doi.org/10.1212/01.wnl.0000345670.63363.d1
Schmidt, A., Jabusch, H.-C., Altenmüller, E., Kasten, M., & Klein, C. (2013). Challenges of making music: What causes musician’s dystonia? JAMA Neurology, 70(11), 1456–1459. https://doi.org/10.1001/jamaneurol.2013.3931
Steinmetz, A., Stang, A., Kornhuber, M., Röllinghoff, M., Delank, K.-S., & Altenmüller, E. (2014). From embouchure problems to embouchure dystonia? A survey of self-reported embouchure disorders in 585 professional orchestra brass players. International Archives of Occupational and Environmental Health, 87(7), 783–792. https://doi.org/10.1007/s00420-013-0923-4

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