Objective: To investigate patterns of gray matter alterations in professional brass musicians with embouchure dystonia (ED) in relation to healthy professional brass musicians and to healthy non-musicians.

Background: ED leads to a loss of fine motor control of the highly trained (oro)facial muscles of professional brass players. Recent functional imaging has suggested central sensorimotor overactivity in this disease. For healthy non-brass musicians, structural gray matter changes in sensorimotor cortices have been reported in the past. Neurophysiologic studies have suggested cortical plasticity as a mechanism for cortical alterations in both healthy musicians and in those suffering from task-specific dystonia.

Methods: We acquired high-resolution T1-weighted MRI scans in 16 professional brass players with diagnosed ED, 16 healthy professional brass players and 17 healthy non-musicians. Structural changes between groups were then investigated using voxel-based morphometry in a voxel-wise whole-brain analysis of (i) gray matter volume and (ii) gray matter asymmetry.

Results: Musicians with ED showed an increased gray matter volume in the bilateral primary motor cortex compared to healthy brass musicians. The comparison to healthy non-musicians additionally revealed a reduced left primary motor cortical volume in healthy brass musicians. Further, the left thalamic volume was increased in both diseased and healthy brass musicians compared to healthy non-musicians. The analysis of gray matter asymmetries additionally revealed a leftward lateralization in the primary somatosensory cortex and the dorsal supplementary motor area in both diseased and healthy brass musicians while non-musicians rather displayed a rightward lateralization in these regions. The extracted mean asymmetry indices in these regions further suggested that this leftward asymmetry was more pronounced in musicians with ED than in healthy musicians.

Conclusions: The finding of gray matter changes in functionally interacting areas in the sensorimotor system supports the concept of maladaptive plasticity in task-specific dystonias such as ED. The pattern of changes may further hint at a disarrangement of initially beneficial adaptive structural changes in musician’s dystonia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sensorimotor-gray-matter-changes-in-professional-brass-players-with-and-without-embouchure-dystonia/