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Movement disorders
Sensorimotor skills and focal dystonia are linked to putaminal grey-matter volume in pianists
  1. Oliver Granert1,
  2. Martin Peller1,2,
  3. Hans-Christian Jabusch3,4,
  4. Eckart Altenmüller4,
  5. Hartwig Roman Siebner1,2,5
  1. 1Department of Neurology, University Hospital Schleswig Holstein, Kiel, Germany
  2. 2NeuroImageNord, Hamburg, Kiel, Lübeck, Germany
  3. 3Institute of Musicians' Medicine, University of Music Carl Maria von Weber, Dresden, Germany
  4. 4Institute of Music Physiology and Musicians' Medicine, University of Music, Drama, and Media, Hannover, Germany
  5. 5Danish Research Centre for Magnetic Resonance, Hvidovre University Hospital, Copenhagen, Denmark
  1. Correspondence to Oliver Granert, Department of Neurology, University Hospital Schleswig-Holstein, Kiel Campus, Arnold-Heller-Str 3, Building No 41, Kiel D-24105, Germany; o.granert{at}


Background Focal hand dystonia has been associated with morphometric changes and distorted somatotopic representations in the putamen.

Objective The authors used voxel-based morphometry (VBM) to identify regions in the putamen where grey-matter volume is associated with musician's dystonia (MD) or the skill level of piano playing in professional pianists.

Methods In 11 pianists with MD affecting the right hand and 12 healthy pianists without dystonia, the authors performed high-resolution T1-weighted MRI of the brain. The authors also measured the temporal variability of key strokes during scale playing with the right hand to characterise the individual skill level of piano playing. Statistical comparisons of the normalised and smoothed grey-matter maps were performed to test for dystonia and performance-related structural changes in the putamen.

Results During scale playing, the timing of consecutive key strokes was more variable in MD patients than in non-dystonic pianists. Regional grey-matter volume in the middle part of left and right putamen increased with timing variability during piano playing in pianists with and without MD. Between-group comparisons revealed that MD patients had a larger grey-matter volume in the right middle putamen compared with healthy musicians.

Conclusion In highly trained pianists with and without MD, the volume of the associative motor territory in the middle putamen reflects both the skill level of piano playing and the presence of dystonia. While a smaller volume is associated with better timing skills, a relative expansion is correlated with the presence of focal task-specific hand dystonia.

  • Putamen
  • focal dystonia
  • dystonic disorders
  • globus pallidus
  • brain mapping
  • dystonia
  • movement disorders
  • MRI

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  • OG and MP contributed equally.

  • Funding This study was supported by a project grant from the Deutsche Forschungs-gemeinschaft (DE 438/7 and 7-2). HRS was funded by a structural grant of the BMBF to Neuroimage Nord (grant no 01GO 0511).

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the ethics committee of the Christian-Albrechts-University Kiel, Germany.

  • Provenance and peer review Not commissioned; externally peer reviewed.