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Focal dystonia in musicians in Brazil

Grant number: 12/10544-5
Support type:Regular Research Grants
Duration: February 01, 2013 - January 31, 2015
Field of knowledge:Health Sciences - Collective Health - Epidemiology
Principal researcher:Henrique Ballalai Ferraz
Grantee:Henrique Ballalai Ferraz
Home Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
Assoc. researchers:Graziela Bortz ; Patrícia Maria de Carvalho Aguiar ; Rita de Cássia dos Reis Moura


The musician's focal dystonia is a type of occupational focal dystonia (unchained by a specific motor action), and its primary cause is unknown. As focal dystonia, it is localized, involuntary, and unchained by simultaneous action of agonist and antagonist muscles; it induces to abnormal muscle movements and/or postures of hands and fingers, essentially, and, sometimes, affects the face (embouchure), or of the neck. Those symptoms usually happen without the presence of pain (a process named Excellence Disorder), and they are caused by specific tasks that demand highly specialized movements - professional abilities of specialized motor action. There is evidence of alteration in the motor and sensitive cortical representations that result in an altered integration of the sensorial information from peripheral to adjacent areas that interfere in the motor program. In Brazil, the focal dystonia is not an object of discussion and interest in musicians' community; innumerous cases are diagnosed when it is too late.Objectives: The goal of this research is to evaluate clinical and epidemiological profile of patients with musician's focal dystonia in national scale in order to apply protocols of evaluation in a systematic pattern. Material and method: A specific questionnaire to verify signs and symptoms experienced by musicians in their daily life will be applied after elucidative lectures taken in orchestras and universities through the whole country: São Paulo (different cities), Rio de Janeiro, Espírito Santo, Minas Gerais, Goiás, Paraná, Bahia, Paraíba, Rio Grande do Norte, Rio Grande do Sul, Ceará, Brasília, Pernambuco, and Santa Catarina. Professional musicians and students who suspect they present movement disorders will be required to present themselves to the lecture. A video will be made with musicians that feel lack of control while realizing specific activities that provoke the disorder. The scale of Hamilton's Anxiety will be applied. The film will be evaluated by two specialists in order to detect or not the presence of dystonia and its classification through Tubiana's scale will be made. The musician could be led to medical centers of reference in focal dystonia in case he or she wants to receive a better follow up. Expected results: From the above, it is expected: a) to establish a model for the evaluation and sensitization of the classes involved in the problem that facilitate early diagnoses of the musician's focal dystonia; b) to install a data basis in national level that facilitates a fast mobilization for multicenter studies; c) to consolidate an effective approach of the problem, and to reduce the index of leave of absence of this professional category. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
MOURA, RITA C.; DE CARVALHO AGUIAR, PATRICIA MARIA; BORTZ, GRAZIELA; FERRAZ, HENRIQUE BALLALAI. Clinical and Epidemiological Correlates of Task-Specific Dystonia in a Large Cohort of Brazilian Music Players. FRONTIERS IN NEUROLOGY, v. 8, MAR 6 2017. Web of Science Citations: 2.

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