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IN33-TU-03 Dystonia in musicians
S26
19th World Congress of Neurology, Invited Abstracts / Journal of the Neurological Sciences 285 S1 (2009) S5–S56
spastic paraplegia. Alcoholic polyneuropathy and encephalopathies are aggravated by vitamins deficiencies, poor diet, intestinal misabsortion, liver diseases, glucidic dysmetabolism, denutrition during severe cancer, vomiting, anorexia and AIDS. Even if it is rarer than previous years, Kwashiorkor occurs in situation of poverty, famine, durable socio-political unrest, drought and natural disasters. In many countries, the mass interventions against iron deficiencies, vitamin A and iodine deficit for children and pregnant women, must be reinforced. At the level of the health services, intervention programs must be elaborated to: – develop tools of education and counseling for primary and secondary prevention, – develop guidelines for facilitating the management of the targeted diseases, – imply the health agents of peripheral and central levels of the health system, – encourage specific nutritional programs for children and pregnant women, – make rapid diagnosis of nutritional deficiencies in vitamins and minerals that could have a severe impact on mother and child and alter their mental and physical status and development – set up nationwide measures for the prevention of the iodine deficiency and its consequences. IN32-TU-03 Environment risk factors for Alzheimer’s disease G. Roman. United States
lesions developed afterwards artistic skills for playing a musical instrument, painting or dancing. Katherine Sherwood, professor of art suffered a severe dominant hemisphere stroke, but she continued to paint with her left hand. She herself describes her recent work as unburdened and uninhibited by consciousness. Lovis Corinth suffered stroke with left side hemiparesis that leaded to change from his naturalistic style of art to expressionistic phase. After stroke he started to use more vibrant colors and created very powerful portraits and landscapes. The important role in the work of Vincent van Gogh have his neuropsychiatric conditions. Many authors are speculating if his paintings in the last years of life are influenced by epilepsy, migraine or bipolar disorder. The great Italian painter Giorgio de Chirico, famous for his unique style of art suffered from migraine. This experience resulted in paintings that regularly present migraine aura and symptoms. Although it can be concluded that the creativity is uninhibited in some neurological disorders, unfortunately dementia in moderate and severe stage of disease leads to extreme changes in artists working pattern and to incapacity to paint. De Kooning was diagnosed with Alzheimer disease in the 1980s with rapid and impressive decline of his work quality. Making art is a magnificent human talent, the complex interrelationship of delicate brain function. Neuroscience offers numerous explanations about the amazing phenomenon how neurological illness can change and even improve artistic expression. IN33-TU-03 Dystonia in musicians K. Rosenkranz. UCL Institute of Neurology, London, United Kingdom
IN33 – Neurology and arts IN33-TU-01 The neurology of famous musicians and composers: Maurice Ravel and neurodegenerative disease B.R. Matthews. Neurology, Indiana University School of Medicine, Indianapolis, United States As neuroscience continues to explore the neural underpinnings of musical skills and creativity with advanced techniques in functional neuroimaging and neurochemical modeling, further reflection on famous musicians and composers known to have been affected by neurological disease is warranted. Following a brief survey of American composers who endured neurological illnesses, the focus of this presentation will be Maurice Ravel. Ravel (1875–1937), a French composer who showed musical promise upon entering the Paris Conservatory as a teenaged pianist, may be best known for one of his late-career compositions, “Bolero”. The piece represents a distinct departure from Ravel’s previous style and may offer the earliest clues to an underlying neurodegenerative disorder. While the precise onset of his neurobehavioral symptoms remains controversial, Ravel’s legacy of compositions and remarkable orchestration may offer timely insights into the insidious nature of degenerative neuropathology and the importance of hemispheric specialization in human behavior. IN33-TU-02 Neurological disorders in famous painters V. Demarin. Department of Neurology, Sestre Milosrdnice University Hospital, Zagreb, Croatia Development of the neuroscience has brought the new insight in the art making processes. Results of the studies have showed that creative people have less prominent hemispheric dominance. Since the centers for visual conception are located in the right brain hemisphere, it was found that patients with right-sided brain lesion have difficulties imagining a picture of a named object. Many examples are showing that left hemisphere suppresses creative states and processes. Some patients with left-sided brain
Musician’s dystonia is a form of focal dystonia that manifests itself as a task-specific loss of voluntary motor control in extensively rehearsed complex movement patterns on the instrument. It is estimated that 1–2 % of professional musicians are affected. The symptoms usually start at an early stage of a musical career and very often lead to its termination. In most musician’s dystonia patients the motor control of the fine hand or finger movements is affected, and only in few cases the control of the embouchure muscles. The exact pathophysiology of this disorder is still a matter of intensive research. The current hypothesis is that intrinsic as well as extrinsic/environmental factors might contribute to the pathophysiology. The idea that excessive repetition of specific movements during musical training might induce a functional and structural adapation of the brain beyond a level that is functionally beneficial has been very influential, and might account for the different neurophysiological findings in musicians and non-musicians affected by focal hand dystonia. This presentation intends to give an overview over the clinical presentation of dystonia in musicians, the epidemiology, some experimental findings and pathophysiological concepts derived from them, as well as specific approaches to therapy.
IN34 – Multiple sclerosis 4 IN34-TU-01 Disease modifying drugs: what and when G. Comi. Department of Neurology, Clinical Neurophysiology and Neurorehabilitation, University Vita-Salute, Milan, Italy IN34-TU-02 Therapeutic advances in multiple sclerosis D. Goodin. Department of Neurology, University of California, San Francisco, United States IN34-TU-03 Molecular target therapy in demyelinating diseases M. Freedman. The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
19th World Congress of Neurology, Invited Abstracts / Journal of the Neurological Sciences 285 S1 (2009) S5–S56
spastic paraplegia. Alcoholic polyneuropathy and encephalopathies are aggravated by vitamins deficiencies, poor diet, intestinal misabsortion, liver diseases, glucidic dysmetabolism, denutrition during severe cancer, vomiting, anorexia and AIDS. Even if it is rarer than previous years, Kwashiorkor occurs in situation of poverty, famine, durable socio-political unrest, drought and natural disasters. In many countries, the mass interventions against iron deficiencies, vitamin A and iodine deficit for children and pregnant women, must be reinforced. At the level of the health services, intervention programs must be elaborated to: – develop tools of education and counseling for primary and secondary prevention, – develop guidelines for facilitating the management of the targeted diseases, – imply the health agents of peripheral and central levels of the health system, – encourage specific nutritional programs for children and pregnant women, – make rapid diagnosis of nutritional deficiencies in vitamins and minerals that could have a severe impact on mother and child and alter their mental and physical status and development – set up nationwide measures for the prevention of the iodine deficiency and its consequences. IN32-TU-03 Environment risk factors for Alzheimer’s disease G. Roman. United States
lesions developed afterwards artistic skills for playing a musical instrument, painting or dancing. Katherine Sherwood, professor of art suffered a severe dominant hemisphere stroke, but she continued to paint with her left hand. She herself describes her recent work as unburdened and uninhibited by consciousness. Lovis Corinth suffered stroke with left side hemiparesis that leaded to change from his naturalistic style of art to expressionistic phase. After stroke he started to use more vibrant colors and created very powerful portraits and landscapes. The important role in the work of Vincent van Gogh have his neuropsychiatric conditions. Many authors are speculating if his paintings in the last years of life are influenced by epilepsy, migraine or bipolar disorder. The great Italian painter Giorgio de Chirico, famous for his unique style of art suffered from migraine. This experience resulted in paintings that regularly present migraine aura and symptoms. Although it can be concluded that the creativity is uninhibited in some neurological disorders, unfortunately dementia in moderate and severe stage of disease leads to extreme changes in artists working pattern and to incapacity to paint. De Kooning was diagnosed with Alzheimer disease in the 1980s with rapid and impressive decline of his work quality. Making art is a magnificent human talent, the complex interrelationship of delicate brain function. Neuroscience offers numerous explanations about the amazing phenomenon how neurological illness can change and even improve artistic expression. IN33-TU-03 Dystonia in musicians K. Rosenkranz. UCL Institute of Neurology, London, United Kingdom
IN33 – Neurology and arts IN33-TU-01 The neurology of famous musicians and composers: Maurice Ravel and neurodegenerative disease B.R. Matthews. Neurology, Indiana University School of Medicine, Indianapolis, United States As neuroscience continues to explore the neural underpinnings of musical skills and creativity with advanced techniques in functional neuroimaging and neurochemical modeling, further reflection on famous musicians and composers known to have been affected by neurological disease is warranted. Following a brief survey of American composers who endured neurological illnesses, the focus of this presentation will be Maurice Ravel. Ravel (1875–1937), a French composer who showed musical promise upon entering the Paris Conservatory as a teenaged pianist, may be best known for one of his late-career compositions, “Bolero”. The piece represents a distinct departure from Ravel’s previous style and may offer the earliest clues to an underlying neurodegenerative disorder. While the precise onset of his neurobehavioral symptoms remains controversial, Ravel’s legacy of compositions and remarkable orchestration may offer timely insights into the insidious nature of degenerative neuropathology and the importance of hemispheric specialization in human behavior. IN33-TU-02 Neurological disorders in famous painters V. Demarin. Department of Neurology, Sestre Milosrdnice University Hospital, Zagreb, Croatia Development of the neuroscience has brought the new insight in the art making processes. Results of the studies have showed that creative people have less prominent hemispheric dominance. Since the centers for visual conception are located in the right brain hemisphere, it was found that patients with right-sided brain lesion have difficulties imagining a picture of a named object. Many examples are showing that left hemisphere suppresses creative states and processes. Some patients with left-sided brain
Musician’s dystonia is a form of focal dystonia that manifests itself as a task-specific loss of voluntary motor control in extensively rehearsed complex movement patterns on the instrument. It is estimated that 1–2 % of professional musicians are affected. The symptoms usually start at an early stage of a musical career and very often lead to its termination. In most musician’s dystonia patients the motor control of the fine hand or finger movements is affected, and only in few cases the control of the embouchure muscles. The exact pathophysiology of this disorder is still a matter of intensive research. The current hypothesis is that intrinsic as well as extrinsic/environmental factors might contribute to the pathophysiology. The idea that excessive repetition of specific movements during musical training might induce a functional and structural adapation of the brain beyond a level that is functionally beneficial has been very influential, and might account for the different neurophysiological findings in musicians and non-musicians affected by focal hand dystonia. This presentation intends to give an overview over the clinical presentation of dystonia in musicians, the epidemiology, some experimental findings and pathophysiological concepts derived from them, as well as specific approaches to therapy.
IN34 – Multiple sclerosis 4 IN34-TU-01 Disease modifying drugs: what and when G. Comi. Department of Neurology, Clinical Neurophysiology and Neurorehabilitation, University Vita-Salute, Milan, Italy IN34-TU-02 Therapeutic advances in multiple sclerosis D. Goodin. Department of Neurology, University of California, San Francisco, United States IN34-TU-03 Molecular target therapy in demyelinating diseases M. Freedman. The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada