I often talk of the differences between a ‘nuts and bolt’s approach to focal dystonia (ie. studying the neurology, changes in the basal ganglia etc) vs. the merits of a hands-on recovery programme.
Personally, I have seen far greater rehabilitation rate in musicians with focal dystonia when applying recovery programmes, than when simply talking about and understanding the neurological mechanisms responsible for focal dystonia.
However, that is not to devalue the research that has taken place over recent years regarding focal dystonia in any way. In fact, it would be extremely interesting to note possible changes in the basal ganglia in musicians with focal dystonia both before and after rehabilitation.
However, for now, back to the basal ganglia:
Basal Ganglia: General information
The basal ganglia (sometimes referred to as the basal nuclei) are a group of nuclei in our brain. They are individual nuclei that work together and function as a unit. The location of the basal ganglia is at the base of the forebrain, and they are strongly connected with the cerebral cortex, thalamus, and other brain areas.
What do the basal ganglia do?
The basal ganglia are involved in several of our functions, including voluntary motor control, procedural learning which relates to learned or common behaviors, actions, tasks, or habits, such as eye movements, teeth grinding, cognitive, and emotional functions.
There are theories that claim the basal ganglia are important in terms of action selection. That is, making a decision based upon several possible actions and then acting upon it. There is also evidence to show that the basal ganglia can inhibit several of our motor systems. When the basal ganglia releases its inhibition, the affected motor system is then able to be activated.
The basal ganglia play an important part in a number of neurological-based movement disorders, including Parkinson’s disease, Huntington’s disease, and dystonias. Tourettes, hemiballismus, obsessive–compulsive disorder, and Wilson’s disease are also affected by the basal ganglia
Basal Ganglia and Focal Dystonia
It has been shown by Satomi Chiken, Pullanipally Shashidharan, and Atsushi Nambu of the National Institute for Physiological Sciences (NIPS) in Japan that decreased activity of the basal ganglia is the main cause of abnormal muscle constrictions of dystonia. Their paper “Cortically Evoked Long-Lasting Inhibition of Pallidal Neurons in a Transgenic Mouse Model of Dystonia” can be read here.
What does this mean for a musician with focal dystonia?
The above is what I call a nuts-and-bolts approach to focal dystonia. It is the standard Western model of dissection and understanding of the components, the actual processes, that contribute to the condition. And again I must state that this understanding is useful and necessary.
However, if you are musician with focal dystonia, understanding the neurological processes behind your focal dystonia symptoms does not directly aid you in your recovery. I believe that if you focus purely on the neurological mechanics of task specific focal dystonia, you are not seeing the woods for the trees.
As a musicians, we need to find solutions to our focal dystonia. If you were physically able to access your basal ganglia and make the necessary adjustments to reverse your focal dystonia symptoms, and prevent those symptoms from occuring again, of course you’d probably do this! But this is not how our brains, bodies, and nervous systems work. At the time of writing this, there is no quick-fix to learning free and efficient playing on any instrument. (Although wouldn’t it be great if there were! We could take a pill and suddenly be able to play guitar like Eddie van Halen, trumpet like Wynton Marsalis, and violin like Maxim Vengerov – all in the same day! 🙂 I digress…)
So how do we solve the problem of damaged or weakened basal ganglia? We induce neuroplasticity.
This post is already too long to go deeply into the subject of neuroplasticity, however, again in my understanding only, it seems possible to re-route neural pathways. This is my best guess as to what happens when we recover from Musician’s Focal Dystonia. The old road connecting two points is broken. We re-route, and make a new one. This is what I believe has happened in my own case, and in the case of the other musicians that have recovered from focal dystonia. All this, without any knowledge of basal ganglia.
What’s your take on the above? Have you discovered any interesting research you’d like to share?
If so, please add your comments and links below.