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Tongue position variability during sustained notes in healthy vs dystonic horn players using real-time MRI.

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Frahm,  J.
Biomedical NMR Research GmbH, MPI for biophysical chemistry, Max Planck Society;

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Voit,  D.
Biomedical NMR Research GmbH, MPI for biophysical chemistry, Max Planck Society;

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Joseph,  A.
Biomedical NMR Research GmbH, MPI for biophysical chemistry, Max Planck Society;

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Citation

Iltis, P. W., Frahm, J., Altenmüller, E., Voit, D., Joseph, A., & Kozakowski, K. (2019). Tongue position variability during sustained notes in healthy vs dystonic horn players using real-time MRI. Medical Problems of Performing Artists, 34(1), 33-38. doi:10.21091/mppa.2019.1007.


Cite as: http://hdl.handle.net/21.11116/0000-0003-1852-6
Abstract
Embouchure dystonia (EmD) is a variant of focal task-specific dystonia in musicians characterized by the loss of control in facial and oral muscles while controlling airflow into the mouthpiece of a wind or brass instrument. We compared tongue position variability (TPV) during sustained notes between healthy, elite horn players and horn players affected by EmD. METHODS: Real-time MRI films at 33.3 ms resolution were obtained from 8 healthy elite and 5 EmD horn players as they performed on a non-ferromagnetic horn at each of three different dynamic levels: pianissimo, mezzo forte, and fortissimo. Nine profile lines (3 from anterior, 3 from middle, and 3 from posterior oral cavity regions) were overlaid on each image using a customized MATLAB toolkit, and the variability of the dorsal tongue edge position was examined at each dynamic from temporal intensity profiles produced by MATLAB. RESULTS: Despite trends for more pronounced TPV (larger standard deviations) in the elite musicians (p=0.062), 2-way repeated measures ANOVA revealed no significant differences between groups. However, dynamic level significantly influenced TPV for all subjects, combined (p=0.048) and different regions of the oral cavity showed differing TPV (p<0.001). When only the most active region (anterior oral cavity) was included in the model, differences between groups reached statistical significance (elite > EmD, p<0.048), particularly at the fortissimo dynamic. We postulate that these differences may be due, in part, to a greater degree of generalized orofacial muscle tension in the EmD subjects that includes the tongue.