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From The Cover
Neuroscience
Effective behavioral treatment of focal hand dystonia in musicians alters somatosensory cortical organization

Victor Candia ^* , Christian Wienbruch ^*, Thomas Elbert ^*, Brigitte Rockstroh ^*, and William Ray 

^*Department of Psychology, University of Konstanz, Fach D25, D-78457 Konstanz, Germany; and Department of Psychology, Pennsylvania State University, University Park, PA 16802

Edited by James L. McClelland, Carnegie Mellon University, Pittsburgh, PA and approved April 18, 2003 (received for review February 21, 2003)

New perspectives in neurorehabilitation suggest that behavioral treatments of movement disorders may modify the functional organization of central somatosensory neural networks. On the basis of the assumption that use-dependent reorganization in these networks contributes to the fundamental abnormalities seen in focal dystonia, we treated 10 affected musicians and measured the concomitant somatosensory changes by using whole-head magnetoencephalography. We found that effective treatment, using the method of sensory motor retuning, leads to alterations in the functional organization of the somatosensory cortex. Specifically, before treatment, somatosensory relationships of the individual fingers differ between the affected and unaffected hands, whereas after treatment, finger representations contralateral to the dystonic side become more similar to the less-affected side. Further, somatosensory finger representations are ordered more according to homuncular principles after treatment. In addition, the observed physiologic changes correlated with behavioral data. These results confirm that plastic changes in parallel with emergent neurological dysfunction may be reversed by context-specific, intensive training-based remediation.

Abbreviations: SMR, sensory motor retuning; DES, Dystonia Evaluation Scale; D, digit; MEG, magnetoencephalography.

See commentary on page 7425.

To whom correspondence should be addressed. E-mail: Victor.Candia{at}Uni-Konstanz.de.

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Related Commentary in PNAS:

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