Apollo's curse: causes and cures of motor failures in musicians: a proposal for a new classification.

Abstract

Performing music at a professional level is probably one of the most complex of human accomplishments. Extremely fast and complex temporo-spatially predefined movement patterns have to be learned, memorized, and retrieved with high reliability in order to meet the expectations of listeners. Performing music requires not only the integration of multimodal sensory and motor information and its precise monitoring via auditory and kinesthetic feedback but also emotional communicative skills for a “speaking” rendition of a musical masterpiece. To acquire these specialized auditory–sensory–motor and emotional skills, extensive training periods over many years are a prerequisite, starting in early infancy and passing through stages of increasing physical and strategic complexities. Performance anxiety, linked to high societal pressures, fear of failure, and heightened self-demands is a frequent accompaniment of these learning processes. Motor disturbances in musicians are not uncommon and include mild forms, such as temporary motor fatigue with short-term reduction of motor skills, painful overuse injuries following prolonged practice, anxiety-related motor failures during performances, such as choking under pressure, and more persistent losses of motor control, here termed “dynamic stereotypes.” Musician’s dystonia, characterized by the permanent loss of control of highly skilled movements when playing a musical instrument, is the most grave manifestation of dysfunctional motor programs, frequently linked to a genetic susceptibility to develop such motor disturbances. In this chapter, we propose a new classification of motor failures in musicians based on the different degrees of “motor” or “psychological” mechanisms involved in the development of these disturbances. We argue that motor failures in musicians develop on a continuum, starting with subtle transient degradations, due to fatigue, overuse, or performance stress, which by and by transform into more permanent, still fluctuating motor degradations, the dynamic stereotypes, until a more irreversible condition, musician’s dystonia manifests. This new classification has implications for specific prevention strategies and for a client-tailored treatment.