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INTRODUCTION: Attention and working memory are key cognitive functions that allow us to select and maintain information in our mind for a short time, being essential for our daily life and, in particular, for learning and academic performance. It has been shown that musical training can improve working memory performance, but it is still unclear if and how the neural mechanisms of working memory and particularly attention are implicated in this process. In this work, we aimed to identify the oscillatory signature of bimodal attention and working memory that contributes to improved working memory in musically trained children. MATERIALS AND METHODS: We recruited children with and without musical training and asked them to complete a bimodal (auditory/visual) attention and working memory task, whereas their brain activity was measured using electroencephalography. Behavioral, time-frequency, and source reconstruction analyses were made. RESULTS: Results showed that, overall, musically trained children performed better on the task than children without musical training. When comparing musically trained children with children without musical training, we found modulations in the alpha band pre-stimuli onset and the beginning of stimuli onset in the frontal and parietal regions. These correlated with correct responses to the attended modality. Moreover, during the end phase of stimuli presentation, we found modulations correlating with correct responses independent of attention condition in the theta and alpha bands, in the left frontal and right parietal regions. CONCLUSIONS: These results suggest that musically trained children have improved neuronal mechanisms for both attention allocation and memory encoding. Our results can be important for developing interventions for people with attention and working memory difficulties.

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Metacognition is essential in the musical learning process as it involves understanding the purpose of each task, its planning, execution and evaluation. Considering the relevance of metacognitive processes, our objective in this study was to investigate how expert and beginner musicians manifest and verbalize their metacognitive processes in the context of preparing repertoire for a performance. The method used was a multi-case study carried out in two different contexts: with the five members of a brass quintet made up of professional musicians and with three beginner university violin students. The results obtained indicated that even at different levels of expertise, metacognitive processes were present in the musical practices of participants in the two contexts investigated. It was found that in both cases time management is a component of the preparation process in metacognitive regulation, however, for the beginner violinists in our sample it was a significantly more complex task than for the professional brass players. Regarding the learning monitoring and evaluation processes, it was possible to verify that beginner instrumentalists as well as professional musicians used declarative, conditional and procedural knowledge to carry out and reflect on their musical practices. These results have implications for both the individual and collective study process and for teaching processes. It is also observed that reflective thinking must accompany the processes of individual and collective interpretative-musical practices, considering that the musical results desired by musicians are related to the quality of cognitive, behavioral, affective and motivational undertakings pertinent to control and regulation of metacognitive processes.

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Introduction: This study aimed to investigate the Self-Regulated Learning behaviors of advanced Brazilian and Portuguese musicians and how these processes vary in terms of gender, nationality, musical instrument, quantity of practice, expertise, and professional experience. Methods: 300 participants fully completed the 22-item questionnaire "Attitudes in music practice". The sample comprised of 54.3% males, 44.0% females, and 1% non-binary; 0.7% did not respond. 68.0% (n = 204) were Brazilian, and 32.0% (n = 96) were Portuguese. The mean age was 32.70 years old (SD = 11.261), the mode was 22 years old, with a range of 18 to 66 years. Data analysis procedure included exploratory factor analysis, internal consistency, independent sample t test, analysis of variance (ANOVA), and chi-square tests. Results: Exploratory Factor Analysis generated three factors: Practice Organization, Personal Resources, and External Resources. The results report there are no differences in SRL scores in terms of gender, nationality, and musical instrument. However, One-way ANOVA test results convey differences in SRL scores and the quantity of practice and expertise with those musicians who reported practicing for longer periods scoring more highly than participants who declared spending less time on daily practice. Discussion: The results for the expertise variables suggest that more experienced and older musicians scored higher in Personal Resources and lower in External Resources indicating that, as musicians gain in experience, their metacognitive processes become more evident than the social factors of their performance.

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It is widely established that musicians possess a higher level in certain auditory perceptual abilities when compared to non-musicians. This improvement may be mediated, at least in part, by changes in the cochlear response induced by reflex activation of the olivocochlear efferent system. In this review, we describe and analyze the scientific evidence regarding possible differences in the efferent response in musicians and non-musicians. The main evidence observed is that musicians present a greater robustness of the efferent olivocochlear reflex when measured by suppression of otoacoustic emissions and compared to non-musicians. Analyzing the articles presented in this review, it is possible to point out that the differential role of the efferent effect in musicians is not yet established. There is not enough evidence to support the idea that the olivocochlear system favors comparative changes in the properties of musicians' auditory filters. New studies with psychoacoustic techniques, among others, are needed to measure the effect of the olivocochlear reflex on tuning, gain, compression, or temporal resolution in musicians and non-musicians.

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Professional musicians experience intense social exposure and high levels of preoccupation with their performance and potential negative reactions from the audience, which favor anxiety. Considering that oxytocin (OXT) has a potential therapeutic effect on anxiety, cognitive processes, and decreased psychosocial stress, this study's objective was to assess the effects of a single dose of 24 UI of intranasal OXT among professional singers, during a public singing simulation test, on self-rated performance and mood. This crossover, randomized, double-blinded, placebo-controlled trial addressed 54 male singers with different levels of musical performance anxiety (42% high). The participants took part in different phases of a simulated public singing performance and completed instruments rating their performances (Self Statements During Public Performance- State version) and mood (Visual Analogue Mood Scale). Data were analyzed using ANOVA 2 × 2 for crossover trials. The results show that the use of OXT during the performance and immediate post-stress favored more positive (effect size: d > 1.04) and less negative assessments of musical performance (effect size: d > 1.86) than when placebo was used. No treatment effects were found in any VAMS subscales, indicating no direct anxiolytic effects. The conclusion is that OXT can minimizes social stress, especially during performances. This finding is exploratory and, if confirmed in future studies, may have relevance for musicians, especially those who constantly experience and recognize the impact of negative and catastrophic thoughts on performance and professional activities. Clinical Trial Registration: [https://ensaiosclinicos.gov.br/rg/RBR-5r5sc5], identifier [RBR-5r5sc5].

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Working conditions of musicians are marked by several specific characteristics that differ the occupation from most others in the labor market. For instance, non-pecuniary aspects of the profession may have a greater influence on the individuals who pursue musical activities than in most other occupations. Moreover, musicians are more susceptible to uncertainties in the short run and regarding the duration of their careers. Besides, informality and underemployment rates tend to be higher in the music industry when compared to the rest of the labor market. This paper aims to better understand musician's labor market participation using primary data. We conducted an online survey between February and December 2020, gathering data about working conditions, in particular job satisfaction and turnover, with all the musicians from Belo Horizonte who were registered and not were registered in musician's association. Belo Horizonte is known as a unique city and a highly heterogeneous environment for the development of the music industry. Thus, using work satisfaction indicators and Kaplan-Meier survival model, controlled by personal and work-position variables, this study highlights that most musicians were neither satisfied nor dissatisfied with their work. However, satisfaction was positively correlated with the following characteristics: being protected by social security, having a music career as main occupation, and holding a degree in music. These traits were also important for musicians to remain in the occupation throughout 2020, an atypical period due to the COVID-19 pandemic.

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Musicians frequently complain of musculoskeletal pain due to high mechanical demands, with the cervical spine being the most affected. Increased neuromuscular mechanosensitivity due to repetitive mechanical stress over time has been described in neck pain patients. Nevertheless, the association between musculoskeletal pain and neuromuscular mechanosensitivity in musicians is unknown. Therefore, the aim of this study was to analyze the relationship between neuromuscular tissue mechanosensitivity and neck pain in guitarists. Guitarists with chronic neck pain (n = 70) and without pain (n = 70) were enrolled. Pain and disability were measured by the visual analogue scale and the Neck Disability Index, respectively. The pressure pain threshold (PPT) was bilaterally measured for the upper trapezius and median nerve. Finally, the Upper limb neural test one (ULNT1) was bilaterally measured. The analyses included a 2-by-2 mixed analysis of variance, pairwise comparisons with Bonferroni correction, linear regression model, and multiple linear regression. Our data showed that chronic neck pain guitarists have a lower PPT at all locations compared to healthy guitarists. They also showed a bilateral main effect for pain for ULNT1 compared to healthy guitarists. These results were not affected by the mediator variables. Finally, a relationship between upper trapezius PPT and median nerve PPT was found.

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Introduction One of the major cues that help in auditory stream segregation is spectral profiling. Musicians are trained to perceive a fine structural variation in the acoustic stimuli and have enhanced temporal perception and speech perception in noise. Objective To analyze the differences in spectral profile thresholds in musicians and nonmusicians. Methods The spectral profile analysis threshold was compared between 2 groups (musicians and nonmusicians) in the age range between 15 and 30 years old. The stimuli had 5 harmonics, all at the same amplitude (f0 = 330 Hz, mi4). The third (variable tone) has a similar harmonic structure; however, the amplitude of the third harmonic component was higher, producing a different timbre in comparison with the standards. The subject had to identify the odd timbre tone. The testing was performed at 60 dB HL in a sound-treated room. Results The results of the study showed that the profile analysis thresholds were significantly better in musicians compared with nonmusicians. The result of the study also showed that the profile analysis thresholds were better with an increase in the duration of music training. Thus, improved auditory processing in musicians could have resulted in a better profile analysis threshold. Conclusions Auditory stream segregation was found to be better in musicians compared with nonmusicians, and the performance improved with an increase in several years of training. However, further studies are essential on a larger group with more variables for validation of the results.

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OBJECTIVE: To determine the prevalence of temporomandibular disorders (TMD) in musicians. MATERIALS AND METHODS: Electronic database searches and a manual search were performed. Qualitative and quantitative analysis including risk of bias was performed for studies that met the inclusion criteria. A meta-analysis of proportions with a random effects model was performed, and heterogeneity was explored according to the moderating variable through subgroup analysis and metaregression. The certainty of the evidence was assessed using the GRADE tool. RESULTS: A total of 13 articles were included for the meta-analysis. Pooled prevalence estimate was 52.8% (CI 95%; 33.4%-71.7%) for wind instruments, 53.9% (CI 95%; 42.4%-65.2%) for string instruments and 53.9% (CI 95%; 23.5%-82.7%) for string and wind instruments. The average time of use of the musical instrument explained 82.38%, the heterogeneity between the sizes of the effects observed in the analysis (R2  = 82.38%; P < .0001). For prevalence of TMD, the GRADE criteria were considered very low. CONCLUSION: The overall combined prevalence of TMD in musicians was approximately 53.9%, and musicians who use their instruments daily and for a long period of time may have a higher prevalence of TMD. CLINICAL SIGNIFICANCE: Due to the high prevalence of TMD in musicians, health professionals must be careful not to underestimate signs and symptoms and correctly diagnose these cases.

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Abstract Introduction One of the major cues that help in auditory stream segregation is spectral profiling. Musicians are trained to perceive a fine structural variation in the acoustic stimuli and have enhanced temporal perception and speech perception in noise. Objective To analyze the differences in spectral profile thresholds in musicians and nonmusicians. Methods The spectral profile analysis threshold was compared between 2 groups (musicians and nonmusicians) in the age range between 15 and 30 years old. The stimuli had 5 harmonics, all at the same amplitude (f0 = 330 Hz, mi4). The third (variable tone) has a similar harmonic structure; however, the amplitude of the third harmonic component was higher, producing a different timbre in comparison with the standards. The subject had to identify the odd timbre tone. The testing was performed at 60 dB HL in a sound-treated room. Results The results of the study showed that the profile analysis thresholds were significantly better in musicians compared with nonmusicians. The result of the study also showed that the profile analysis thresholds were better with an increase in the duration of music training. Thus, improved auditory processing in musicians could have resulted in a better profile analysis threshold. Conclusions Auditory stream segregation was found to be better in musicians compared with nonmusicians, and the performance improved with an increase in several years of training. However, further studies are essential on a larger group with more variables for validation of the results.

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ABSTRACT Objective: to analyze whether trombonists present orofacial myofunctional changes and compare the electrical activity of the orbicularis oris muscle before and after playing their instrument. Methods: an observational, descriptive, and cross-sectional study. The sample consisted of 20 university trombonists. Data collection involved three steps: application of a questionnaire investigating some peculiarities of trombonists (Orofacial Myofunctional Evaluation with Expanded Scores - OMES-E), and electromyographic analysis of the orbicularis oris muscle before and after performing a piece with the trombone. The mean, standard deviation, frequency, and percentage were calculated, and the paired Student's t test was used to compare the means of the electromyographic records before and after playing the trombone, at a 5% significance. Results: seventy per cent of trombonists reported some symptom of orofacial myofunctional alteration, namely, muscle compensations, tension, and pain. The myofunctional evaluation showed a mild change in cheek volume (90%) and labial commissure asymmetry (60%). The electrical activity of the lower orbicularis oris muscle decreased significantly after the trombone practice (p = 0.04), while that of the superior orbicularis oris muscle remained unchanged. Conclusion:trombonists show clinical and self-reported oromyofunctional changes as well as decreased electrical activity of the lower orbicularis oris muscle, after playing the trombone.

RESUMO Objetivos: analisar se existem alterações miofuncionais orofaciais clínicas e autorreferidas em trombonistas, assim como comparar a atividade elétrica do músculo orbicular da boca antes e após o uso do trombone. Métodos: estudo transversal e observacional, cuja amostra foi composta por 20 universitários trombonistas. Foi utilizado um questionário que investiga algumas particularidades sobre o instrumentista, da Avaliação Miofuncional Orofacial Com Escores Ampliados - AMIOFE-A e análise eletromiográfica do músculo orbicular da boca antes e após execução de uma tarefa com o trombone. Foram calculadas: média, desvio padrão, frequência e porcentagem e utilizou-se o teste t-Student pareado na comparação das médias dos registros eletromiográficos pré e pós-execução do trombone, significância=5%. Resultados: setenta por centro dos trombonistas relataram algum sintoma de alteração miofuncional orofacial, sendo compensações musculares, tensão e dor. Na avaliação miofuncional encontrou-se alteração leve no volume de bochechas (90%) e comissuras labiais com assimetria (60%). Houve redução significante da atividade elétrica do músculo orbicular inferior após a execução de tarefa com trombone (p=0,04), enquanto a do superior permaneceu inalterada. Conclusão: trombonistas apresentam alterações oromiofuncionais clínicas e autorreferidas e diminuição da atividade elétrica do músculo orbicular inferior da boca após uso do trombone.

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La reserva neural es un subcomponente de la reserva cognitiva y refiere a las diferencias en los paradigmas cognitivos que subyacen al desempeño de tareas en un cerebro sano. Puede darse por diferencias innatas (inteligencia, edad) o ambientales, como el entrenamiento musical. Éste está relacionado con diferencias cerebrales y cognitivas. El objetivo del presente estudio es realizar una revisión bibliográfica de investigaciones que evaluaron rendimiento cognitivo en músicos como no músicos, y establecer diferencias en la reserva cognitiva y, más específicamente, el subcomponente de reserva neural, entre ambos grupos. Se parte de la suposición de que los músicos poseen un rendimiento superior en tareas cognitivas con respecto a los no músicos y que esto está relacionado con una mayor reserva neural debido al entrenamiento musical. Los resultados son contradictorios. Se encontraron algunas diferencias en dominios cercanos a la práctica musical en adultos jóvenes, y en diversos dominios en adultos mayores. Las diferencias entre grupos, que no diferían en inteligencia, podrían ser atribuibles a una mayor reserva cognitiva. También hay relaciones con el tipo de instrumento, los años y la edad de comienzo de la práctica musical. Se sugiere replicar los hallazgos controlando diversas variables(AU)

Neural reserve is a subcomponent of cognitive reserve and refers to the differences in cognitive paradigms that underlie task performance in a healthy brain. It can occur due to innate (intelligence, age) or environmental differences, such as musical training. This is related to brain and cognitive differences. The aim of the present study is to carry out a bibliographic review of investigations that evaluated cognitive performance in musicians as well as non-musicians, and to establish differences in cognitive reserve and, more specifically, the neural reserve subcomponent, between both groups. It is assumed that musicians have superior cognitive tasks performance compared to non-musicians and that this is related to a greater neural reserve due to musical training. The results are contradictory. Some differences were found in domains close to musical practice in young adults, and in various domains in older adults. The differences between groups, which did not differ in intelligence, could be attributable to a greater cognitive reserve. There are also relationships with the type of instrument, the years and the age of beginning of the musical practice. It is suggested to replicate the findings controlling for various variables(AU)

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Abstract Introduction Music performance anxiety (MPA) is characterized by long-lasting, high intensity apprehension associated with performing music in public. At extreme levels, MPA can impair the career and quality of life. Our goal is to describe the clinical profile, perceived causes and coping strategies associated with MPA. Methods In this cross-sectional study, several self-assessment instruments were administered to a sample of 214 Brazilian musicians (68% male, 53.3% classical/46.7% popular musicians). Data were analyzed using descriptive and parametric statistics, based on the variables of musical training and level of MPA. Results Percentages of indicators of pathology were high (40% high MPA levels, 37% social anxiety, 12.5% depression, 13.5% alcohol abuse), and musicians with high MPA levels were the most affected. A wide variety of situations were associated with MPA, especially those related to the individual (pressure from self/concern about audience). Emotion-focused coping and internal resources were prominent among the resources used for coping with MPA (breathing, increased practice, familiarization with performance venue), although they were not always effective. It was relatively uncommon for musicians to seek specialized resources and treatments. Conclusions The results demonstrate the vulnerability of the targeted professional groups and the need for preventive strategies and behavioral, environmental, educational, and pharmacological interventions to change this scenario.

Resumo Introdução Ansiedade de performance musical (APM) é definida como uma condição de apreensão duradoura e intensa, associada ao desempenho musical em público. Em níveis extremos é prejudicial à carreira e qualidade de vida do músico. Objetiva-se descrever o perfil clínico, as causas percebidas e estratégias de enfrentamento da APM. Métodos Neste estudo transversal, vários instrumentos de autoavaliação foram administrados a 214 músicos brasileiros (68% do sexo masculino, 53,3% clássicos/ 46,7% populares). Os dados foram analisados por estatística descritiva e paramétrica, com base nas variáveis formação musical e nível de APM. Resultados Encontrou-se um percentual elevado de indicadores de psicopatologia (40% altos níveis de APM, 37% ansiedade social, 12,5% depressão, 13,5% abuso de álcool), sendo os músicos com altos níveis de APM aqueles com maior comprometimento. Uma ampla variedade de situações foi associada à APM, com destaque para aquelas relacionadas ao próprio indivíduo (pressão de si próprio/preocupação com a plateia). Entre os recursos utilizados para enfrentamento da APM destacaram-se aqueles focados na regulação emocional e no uso de recursos internos dos músicos (respiração, aumento do treino, familiarização com a prática no local da apresentação), embora nem sempre tenham sido eficazes. Mostrou-se pouco comum a busca por recursos e tratamentos especializados. Conclusões Evidencia-se a condição de vulnerabilidade desse grupo profissional e a necessidade de estratégias preventivas e intervenções comportamentais, ambientais, educativas e farmacológicas que permitam mudanças neste cenário.

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Musculoskeletal problems are common in instrumental musicians. Little is known about the factors that place musicians at risk, and the ways in which musicians can prevent these problems. Overuse syndrome is the most reported diagnosis among instrumental musicians suffering from playing related musculoskeletal injuries. The study group comprised 50 musicians employed in Symphony Orchestra of the Serbian National Theatre of Novi Sad. Out of the 50 musicians, 30 (60 %) are male and 20 (40 %) female. Higher frequencies of the presence of musculoskeletal symptoms were neck, region of trapezius, back, shoulder, wrist, hand and arm. A larger number of musicians (81.8 %) had perception of high demand of the profession. This investigation with professional classical musicians should show the music-medical interest.

Los problemas musculo-esqueléticos son comunes en los músicos instrumentales. Poco se sabe sobre los factores que ponen en riesgo a los músicos y las formas en que los ellos pueden prevenir estos problemas. El síndrome de uso excesivo es el diagnóstico más informado entre los músicos instrumentales que sufren lesiones musculo-esqueléticas relacionadas al uso de instrumentos musicales. El grupo de estudio estuvo compuesto por 50 músicos de la Orquesta Sinfónica del Teatro Nacional Serbio de Novi Sad. De los 50 músicos, 30 (60 %) eran hombres y 20 (40 %) mujeres. La frecuencia más alta de presencia de síntomas musculoesqueléticos se produjo en el cuello, músculo trapecio, espalda, hombro, muñeca, mano y brazo. Un mayor número de músicos (81,8 %) tuvo una percepción de alta demanda de la profesión. Esta investigación con músicos clásicos profesionales debería ser de interés médico-musical.

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BACKGROUND: Working memory refers to the cognitive system responsible for the temporary storage and maintenance of information, but it remains controversial whether overlapping processes underlie the temporary retention of verbal and musical information such as words and tones. METHODS: Participants with little or no musical training (n = 22) and professional musicians (n = 21) were administered four memory tasks. Two tasks (tone sequence recognition and pseudoword sequence recall) aimed at comparing groups' performance for tonal or phonological material separately. Other two memory tasks investigated pseudoword and tone recognition under three conditions during the retention interval (silence, irrelevant words, or irrelevant tones). RESULTS: Musicians were better than nonmusicians in tone sequence recognition but not in pseudoword sequence recall. There were no interference effects of irrelevant tones or words on pseudoword recognition, and only irrelevant tones significantly interfered with tone recognition. CONCLUSIONS: Our results offer further support that tone recognition is specifically impaired by irrelevant tones, but irrelevant words did not disrupt pseudoword or tone recognition. Although these results do not reflect a double-dissociation pattern between phonological and tonal working memory, they provide evidence that temporary retention of tonal information is subject to specific tonal interference, indicating that working memory for tones involves specific processes.

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Abstract Background: Working memory refers to the cognitive system responsible for the temporary storage and maintenance of information, but it remains controversial whether overlapping processes underlie the temporary retention of verbal and musical information such as words and tones. Methods: Participants with little or no musical training (n = 22) and professional musicians (n = 21) were administered four memory tasks. Two tasks (tone sequence recognition and pseudoword sequence recall) aimed at comparing groups' performance for tonal or phonological material separately. Other two memory tasks investigated pseudoword and tone recognition under three conditions during the retention interval (silence, irrelevant words, or irrelevant tones). Results: Musicians were better than nonmusicians in tone sequence recognition but not in pseudoword sequence recall. There were no interference effects of irrelevant tones or words on pseudoword recognition, and only irrelevant tones significantly interfered with tone recognition. Conclusions: Our results offer further support that tone recognition is specifically impaired by irrelevant tones, but irrelevant words did not disrupt pseudoword or tone recognition. Although these results do not reflect a double-dissociation pattern between phonological and tonal working memory, they provide evidence that temporary retention of tonal information is subject to specific tonal interference, indicating that working memory for tones involves specific processes.

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Abstract Background Music performance anxiety (MPA) is understood as a sub-type of social anxiety and is characterised by fears of a musical presentation. Objective To carry out a critical literature review on clinical and etiological aspects, perceived causes, coping strategies and treatment of MPA. Methods Electronic databases PubMed, PsycINFO and Lilacs as well as specific periodicals were used based on the key-words symptoms, diagnosis, aetiology, perceived causes, coping strategies and treatment. Results MPA is highly prevalent among musicians (> 16%), regardless of culture and formation. Cognitive, behavioural and physiological factors are associated with the aetiology of MPA, including biological and psychological predispositions. In addition, one should highlight factors related to the individual, aspects related to tasks and musical situation as perceived causes and/or predictor variables of MPA. As for the coping strategies, one can also highlight the use of breathing/relaxing techniques, increased musical practice, use of homeopathy and substances without medical prescription. Discussion MPA is impacting in the musician's life. Despite the increasing interest in its study, it is necessary to better understand this complex phenomenon, mainly in the therapeutic context, in addition to the publicising and offering of services for prevention and treatment of MPA.

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Assessing the neural correlates of motor and cognitive processes under naturalistic experimentation is challenging due to the movement constraints of traditional brain imaging technologies. The recent advent of portable technologies that are less sensitive to motion artifacts such as Functional Near Infrared Spectroscopy (fNIRS) have been made possible the study of brain function in freely-moving participants. In this paper, we describe a series of proof-of-concept experiments examining the potential of fNIRS in assessing the neural correlates of cognitive and motor processes in unconstrained environments. We show illustrative applications for practicing a sport (i.e., table tennis), playing a musical instrument (i.e., piano and violin) alone or in duo and performing daily activities for many hours (i.e., continuous monitoring). Our results expand upon previous research on the feasibility and robustness of fNIRS to monitor brain hemodynamic changes in different real life settings. We believe that these preliminary results showing the flexibility and robustness of fNIRS measurements may contribute by inspiring future work in the field of applied neuroscience.

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Musician's dystonia is a task-specific dystonia (TSD) worldwide disabling disorder, and most of the affected individuals may have severe difficulty to play their instrument. Many professional music players may have to quit working as a player. The objective of the present study was to evaluate the clinical characteristics and frequency of TSD in Brazilian music players and to promote awareness of this condition among musicians. We visited orchestras and music schools delivering lectures on TSD and about the scope of our survey. Musicians were invited to answer a questionnaire, and those with possible neurological dysfunction associated with musical performance were recorded by video while playing the instrument. We visited 51 orchestras and music schools in 19 Brazilian cities between March 2013 and March 2015. We collected 2,232 questionnaires, and 72 subjects with suspicion of dystonia were video recorded during specific tasks and evaluated regarding motor impairment. Forty-nine individuals (2.2%) were diagnosed as having TSD (mean age 36.4 years; 92% male). The instruments most associated with TSD were acoustic guitar (36.7%) and brass instruments (30.6%). We concluded that Brazilian TSD music players are mainly male, classical music professionals, around 30 years of age, with arms, hands, or oromandibular muscles affected. TSD is a neurological condition that can impair musical performance and should receive more attention from musicians, teachers, and health professionals.

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In Response To: Frucht SJ. Focal task-specific dystonia-from early descriptions to a new, modern formulation. Tremor Other Hyperkinet Mov. 2014; 4. doi: 10.7916/D8VD6WHP.