{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T10:44:15Z","timestamp":1790505855202,"version":"4.1.0"},"reference-count":70,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:00:00Z","timestamp":1615248000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>ABSTRACT:<\/jats:title><jats:p>Overuse of specific muscles in perfecting movements in performing arts makes an artist prone to many medical conditions. Musicians\u2019 hand dystonia is focal task-specific dystonia (FTSD) of hand among musicians that has been extensively studied. However, embouchure, lower limbs, and laryngeal muscles can also be affected among musicians. Embouchure dystonia (ED) refers to dystonia of the perioral and facial muscles that occurs in musicians while playing embouchure instruments. It is essential to identify ED since the dystonia might become persistent and non-task-specific if the musician continues to play the instrument. Task-specific dystonia of lower limbs among musicians has been exclusively reported among drummers. The diagnosis rests on electromyogram (EMG) of the involved muscles during the task. Singer\u2019s dystonia (SD) refers to task-specific laryngeal dystonia that occurs only while singing. The diagnosis of SD is based on laryngeal EMG and spectrographic analysis. Cortical hyperexcitability, loss of inhibition, and aberrant plasticity are central to the pathogenesis in both ED and musicians\u2019 hand dystonia. The pathophysiological studies in SD are limited. This review aims to discuss the lesser known dystonias among performing artists \u2013 ED, FTSD of lower limb, and SD.<\/jats:p>","DOI":"10.1017\/cjn.2021.41","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T05:52:03Z","timestamp":1615269123000},"page":"29-37","source":"Crossref","is-referenced-by-count":12,"title":["Dystonia in Performing Artists: Beyond Focal Hand Dystonia"],"prefix":"10.1017","volume":"49","author":[{"given":"Somdattaa","family":"Ray","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4085-2377","authenticated-orcid":false,"given":"Pramod K.","family":"Pal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,3,9]]},"reference":[{"key":"S031716712100041X_ref39","doi-asserted-by":"publisher","DOI":"10.1177\/000348940611500201"},{"key":"S031716712100041X_ref17","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10647"},{"key":"S031716712100041X_ref5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra055549"},{"key":"S031716712100041X_ref15","first-page":"45","article-title":"Occupational cramp in instrumental musicians","volume":"3","author":"Lederman","year":"1988","journal-title":"Med Probl Perform Art."},{"key":"S031716712100041X_ref10","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870100418"},{"key":"S031716712100041X_ref1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.10380"},{"key":"S031716712100041X_ref43","doi-asserted-by":"publisher","DOI":"10.1097\/01.PHM.0000087458.32122.14"},{"key":"S031716712100041X_ref61","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.24486"},{"key":"S031716712100041X_ref11","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2017.00073"},{"key":"S031716712100041X_ref48","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410440304"},{"key":"S031716712100041X_ref25","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21709"},{"key":"S031716712100041X_ref66","doi-asserted-by":"publisher","DOI":"10.1097\/00001756-200404090-00015"},{"key":"S031716712100041X_ref41","first-page":"S67","article-title":"Singing-induced cervical dystonia","volume":"13","author":"Fabiani","year":"2007","journal-title":"Parkinsonism Relat Disord."},{"key":"S031716712100041X_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(06)70547-6"},{"key":"S031716712100041X_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2013.07.013"},{"key":"S031716712100041X_ref6","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21141"},{"key":"S031716712100041X_ref54","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27649"},{"key":"S031716712100041X_ref27","doi-asserted-by":"publisher","DOI":"10.1597\/06-176.1"},{"key":"S031716712100041X_ref29","doi-asserted-by":"publisher","DOI":"10.21091\/mppa.2004.1004"},{"key":"S031716712100041X_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2014.08.007"},{"key":"S031716712100041X_ref69","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2010.12.001"},{"key":"S031716712100041X_ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-013-0923-4"},{"key":"S031716712100041X_ref64","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870130321"},{"key":"S031716712100041X_ref50","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20270"},{"key":"S031716712100041X_ref57","doi-asserted-by":"publisher","DOI":"10.21091\/mppa.2019.1007"},{"key":"S031716712100041X_ref44","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh402"},{"key":"S031716712100041X_ref46","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1038\/377155a0","article-title":"Functional MRI evidence for adult motor cortex plasticity during motor skill learning","volume":"377","author":"Karni","year":"1995","journal-title":"Nature."},{"key":"S031716712100041X_ref36","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-011-6324-2"},{"key":"S031716712100041X_ref2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25475"},{"key":"S031716712100041X_ref26","doi-asserted-by":"publisher","DOI":"10.1093\/acprof:oso\/9780199298723.003.0017"},{"key":"S031716712100041X_ref19","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21976"},{"key":"S031716712100041X_ref28","doi-asserted-by":"publisher","DOI":"10.1177\/000348949410300803"},{"key":"S031716712100041X_ref60","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26893"},{"key":"S031716712100041X_ref37","first-page":"174","article-title":"Heavy metal curse: a task-specific dystonia in the proximal lower limb of a professional percussionist","volume":"29","author":"Lee","year":"2014","journal-title":"Med Probl Perform Ar."},{"key":"S031716712100041X_ref51","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-003-0942-2"},{"key":"S031716712100041X_ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s10545-005-7495-8"},{"key":"S031716712100041X_ref49","first-page":"267","article-title":"Abnormal sensorimotor processing in pianists with focal dystonia","volume":"94","author":"Lim","year":"2004","journal-title":"Adv Neurol."},{"key":"S031716712100041X_ref55","doi-asserted-by":"publisher","DOI":"10.1186\/s40734-019-0080-3"},{"key":"S031716712100041X_ref21","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8257(199901)14:1<171::AID-MDS1034>3.0.CO;2-1"},{"key":"S031716712100041X_ref8","doi-asserted-by":"publisher","DOI":"10.1002\/mds.1167"},{"key":"S031716712100041X_ref45","doi-asserted-by":"publisher","DOI":"10.1126\/science.8122113"},{"key":"S031716712100041X_ref59","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26664"},{"key":"S031716712100041X_ref7","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25723"},{"key":"S031716712100041X_ref38","first-page":"45","article-title":"Focal dystonia in musicians","volume":"26","author":"Aranguiz","year":"2011","journal-title":"Neurologia"},{"key":"S031716712100041X_ref53","doi-asserted-by":"publisher","DOI":"10.1002\/mds.97"},{"key":"S031716712100041X_ref12","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23526"},{"key":"S031716712100041X_ref42","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.47.2.508"},{"key":"S031716712100041X_ref33","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2012.06456.x"},{"key":"S031716712100041X_ref9","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20353"},{"key":"S031716712100041X_ref68","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/13.2.162"},{"key":"S031716712100041X_ref58","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181e0f784"},{"key":"S031716712100041X_ref18","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880190403"},{"key":"S031716712100041X_ref34","doi-asserted-by":"publisher","DOI":"10.21091\/mppa.2004.2011"},{"key":"S031716712100041X_ref32","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-016-1533-6"},{"key":"S031716712100041X_ref62","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000266591.49624.1a"},{"key":"S031716712100041X_ref56","doi-asserted-by":"publisher","DOI":"10.1016\/j.humov.2015.04.013"},{"key":"S031716712100041X_ref22","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21737"},{"key":"S031716712100041X_ref31","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27298"},{"key":"S031716712100041X_ref20","doi-asserted-by":"publisher","DOI":"10.1186\/s40734-016-0035-x"},{"key":"S031716712100041X_ref47","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.0836-07.2007"},{"key":"S031716712100041X_ref23","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2006.107953"},{"key":"S031716712100041X_ref14","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22550"},{"key":"S031716712100041X_ref63","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-307127"},{"key":"S031716712100041X_ref65","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2019.05.008"},{"key":"S031716712100041X_ref40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2014.04.011"},{"key":"S031716712100041X_ref70","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-018-3480-5"},{"key":"S031716712100041X_ref67","first-page":"1","article-title":"Sensorimotor integration and GABA-ergic activity in embouchure dystonia: an assessment with magnetoencephalography","volume":"9","author":"Bulica","year":"2019","journal-title":"Tremor Other Hyperkinet Mov."},{"key":"S031716712100041X_ref16","first-page":"121","article-title":"Musicians with focal dystonia: a report of 58 cases seen during a 10-year period at a performing arts medicine clinic","volume":"10","author":"Brandfonbrener","year":"1995","journal-title":"Med Probl Perform Art."},{"key":"S031716712100041X_ref52","doi-asserted-by":"publisher","DOI":"10.1002\/ana.10073"},{"key":"S031716712100041X_ref24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2012.06456.x"}],"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S031716712100041X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T13:31:08Z","timestamp":1640611868000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S031716712100041X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,9]]},"references-count":70,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["S031716712100041X"],"URL":"https:\/\/doi.org\/10.1017\/cjn.2021.41","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"value":"0317-1671","type":"print"},{"value":"2057-0155","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,9]]}}}