Musician's dystonia: an opinion on novel treatment strategies

In this opinion paper, we contribute our perspective on the potential of recent findings from relevant pathophysiological contexts to indicate therapeutic approaches in musicians’ dystonia (MD). This neurological condition is mostly painless and highly task-specific, with symptoms only occurring when trying to play the instrument, and includes two most common forms: hand, and embouchure dystonia. We hope to encourage constructive discussion about a multidimensional strategy to alleviate this disabling symptom. In the realm of neuroscientific discourse, our viewpoint on this condition is framed as an opinion that emphasizes the imperative of early and precise diagnosis, alongside the personalized application of therapeutic modalities. This opinion arises from a synthesis of empirical evidence and theoretical insights, advocating for a nuanced approach that extends beyond mere symptom management. We contend that the efficacy of interventions hinges upon a comprehensive understanding of the multifaceted nature of MD, encompassing its neurobiological underpinnings and its psychosocial ramifications. This opinion underscores the necessity of employing a diverse array of intervention strategies: this encompasses interventions targeting the sensorimotor system, such as physiotherapy, via interventions addressing the subcortical domains implicated in memory consolidation, identity integration, and emotion regulation, a paradigm that acknowledges the intricate interplay between neural circuits and psychological processes. By embracing this comprehensive perspective, we aim to foster symptom alleviation, cultivating resilience, adaptive coping mechanisms, and enhanced quality of life for individuals grappling with this challenging neurological condition.