IntroductionProfessional musicians may be exposed to distinctive occupational, psychosocial, and artistic demands, yet integrated evidence on their mental health, psychological resources, and treatment utilization remains scarce. Therefore, this study examined mental health indicators, including symptom burden and self-reported diagnosed mental disorders, personal psychological resources (resilience, self-efficacy, and self-esteem), occupational characteristics, and treatment use in a nationwide sample of professional musicians and music students in Germany.MethodsData were collected through a large, anonymous, longitudinal online survey across different musical genres. Baseline data were obtained from 1,392 participants January–June 2024; 327 participants completed the follow-up in June 2025 (at least 1 year after baseline). Descriptive analyses, subgroup comparisons, cross-sectional regression models, and longitudinal regression models were used to examine symptom burden, diagnoses, resources, sociodemographic and occupational differences, and change over time.ResultsAt baseline, clinically relevant symptom levels were common: 30% of participants scored in the moderate or severe range for generalized anxiety symptoms, 32% scored in the moderate to severe range for depressive symptoms, and 22% reported a current diagnosed mental disorder. Employment status emerged as the most consistent subgroup correlate, with additional differences by gender, job role, and genre. Resilience, self-efficacy, and self-esteem were each negatively associated with depressive symptoms, generalized anxiety symptoms, and music performance anxiety, with self-esteem showing particularly strong associations. Overall, mental health indicators and personal resources were largely stable over 12 months, while music students reported higher depressive symptoms at follow-up beyond baseline levels. Treatment utilization was substantial, with half of participants reporting lifetime treatment for psychological complaints.DiscussionThese findings indicate a substantial and unevenly distributed mental health burden among professional musicians in Germany. Although interpretation is limited by the observational design, non-probabilistic sampling, reliance on self-report, and substantial attrition at follow-up, the findings point to the relevance of prevention and support strategies that adequately address psychological resources and occupational conditions. Such provision may be broadly accessible while remaining responsive to differences in employment status, genre, gender-related experiences, barriers to care, support needs, and individual characteristics and contexts. These implications may guide future research and context-sensitive practice, although their effectiveness and clinical relevance require further evaluationClinical trial registrationThe study was pre-registered in the German Clinical Trials Register in January 2024 (https://drks.de/search/en/trial/DRKS00033401).

BACKGROUND:Substance use is commonly assumed to be widespread among musicians; however, empirical data on consumption patterns and the associations with anxiety are limited and heterogeneous. In particular, differentiated longitudinal findings across substances and musical genres are lacking. OBJECTIVE:Therefore, the aim of this study was to investigate the use of various psychoactive substances among professional musicians from different genres, including the examination of changes over time and associations with (performance) anxiety. MATERIAL AND METHODS:An anonymous online study with two assessment waves (T1: January-June 2024, T2: June 2025) was conducted; 1392 musicians (including music students) participated in T1, of whom 327 also took part in T2. The frequency of use for 16 substances, indicators of problematic substance use (Cut down, Annoyed, Guilty, Eye-opener-adapted to include drugs, CAGE-AID), performance anxiety (stage anxiety questionnaire, BAF), and general anxiety symptoms (GAD-7) were assessed. RESULTS:Overall, a generally elevated prevalence of substance use was not observed. Alcohol was the most frequently used substance and 21% of participants showed a positive screening for problematic substance use. Musicians in popular/jazz genres tended to report higher levels of substance use than classical musicians. Cross-sectionally, weak associations between some substances and performance anxiety were observed. Longitudinally, cross-lagged panel models indicated minimal changes over time and no significant longitudinal effects between substance use and anxiety. DISCUSSION:The findings do not provide evidence for generally increased levels of substance use among musicians but point to individual risk profiles that should be considered when providing care for this population.

Substanzkonsum gilt bei Musiker:innen als weit verbreitet, empirische Daten zu Konsummustern und Zusammenhängen mit Ängsten sind jedoch begrenzt und heterogen. Insbesondere fehlen differenzierte längsschnittliche Befunde über verschiedene Substanzen und Genres hinweg. Ziel der Arbeit war daher die Untersuchung des Konsums unterschiedlicher psychoaktiver Substanzen bei professionellen Musiker:innen verschiedener Genres, inklusive der Betrachtung zeitlicher Veränderungen sowie der Zusammenhänge mit (Auftritts‑)Ängsten. Es wurde eine anonyme Onlinestudie mit zwei Erhebungszeitpunkten (T1: 01–06/2024, T2: 06/2025) durchgeführt; 1392 Musiker:innen (inklusive Musikstudierenden) nahmen an T1 teil, 327 davon auch an T2. Erfasst wurden Konsumhäufigkeiten für 16 Substanzen, Abhängigkeitsindikatoren (CAGE-AID), Auftrittsangst (BAF) sowie unspezifische Angstsymptome (GAD-7). Insgesamt zeigten sich keine grundsätzlich erhöhten Konsumprävalenzen. Alkohol war die am häufigsten konsumierte Substanz und bei 21

Professional musicians are often confronted with multiple profession-related stressors, which may be associated with an increased risk of mental strain, but empirical evidence focusing on clinical samples of musicians is limited. The aim of this study was to examine clinically confirmed mental disorders and personality accentuations in musicians attending a musician-specific outpatient service, to better understand how occupational and person-related stressors may impact their mental health. We performed a cross-sectional secondary data analysis of diagnoses and sociodemographic data of 678 professional musicians (including music students) that were routinely collected in the outpatient clinic. Of the 678 patients, 110 (16.2%) received a tentative psychiatric diagnosis, and 46 presented themselves to the psychiatric outpatient clinic for extensive diagnostics (using ICD-10 and SKID-II). In these 46 musicians, depression (39%) and music performance anxiety (26%) were the most frequent diagnoses, followed by adjustment disorders (13%) and somatoform disorders (11%). Twenty-eight percent of the sample fulfilled the criteria of either a personality disorder or accentuation. The frequency rates emphasize the importance of targeting the mental health of professional musicians with preventive and therapeutic measures. Further research with larger sample sizes is needed to validate and extend our findings and develop individual preventive measures.

ObjectivesTo investigate the association of musical activity with mental health during the COVID-19 pandemic.MethodsA total of 3,666 participants reported their musical activity before and mental health indicators before and during the pandemic. Depression was assessed with the Patient Health Questionnaire, anxiety with the Generalized Anxiety Disorder scale. The association between mental health scores and musical activities was investigated using linear regression.ResultsWithin the last 12 months, 22.1% of the participants reported musical activity (15.1% singing, 14.5% playing an instrument). Individuals with frequent singing as their main musical activity had higher scores before the pandemic than non-musicians and the worsening during the pandemic was more pronounced compared to non-musicians. Instrumentalists tended to have slightly lower scores than non-musicians indicating a possible beneficial effect of playing an instrument on mental health.ConclusionThe pandemic led to a worsening of mental health, with singers being particularly affected. Singers showed poorer mental health before the pandemic. The tendency for instrumentalists to report lower depression scores compared to non-musicians may support the hypothesis that music-making has a beneficial effect on health.

Abstract Musical activities (MA) such as singing, playing instruments, and listening to music may be associated with health benefits. However, evidence from epidemiological studies is still limited. This study aims at describing the relation between MA and both sociodemographic and health-related factors in a cross-sectional approach. A total of 6717 adults (50.3% women, 49.7% men, median age: 51 years (IQR 43–60) were recruited from the study center Berlin-Mitte of the German National Cohort (NAKO), a population-based prospective study. This study is based on a sample randomly selected from the population registry of Berlin, Germany, aged 20 to 69 years. 53% of the participants had been musically active at least once in their life (56.1% women, 43.9% men). Playing keyboard instruments (30%) and singing (21%) were the most frequent MA. Participants listened to music in median 90 min per day (IQR 30.0–150.0). Musically active individuals were more likely to have a higher education, higher alcohol consumption, were less likely to be physically active, and had a lower BMI compared to musically inactive individuals. This large population-based study offers a comprehensive description of demographic, health, and lifestyle characteristics associated with MA. Our findings may aid in assessing long-term health consequences of MA.

Background The acetylcholinesterase inhibitors (AChEIs) donepezil, galantamine, and rivastigmine are commonly used in the management of various forms of dementia.Objectives While these drugs are known to induce classic cholinergic adverse events such as diarrhea, their potential to cause psychiatric adverse events has yet to be thoroughly examined.Methods We sought to determine the risk of psychiatric adverse events associated with the use of AChEIs through a systematic review and meta-analysis of double-blind randomized controlled trials involving patients with Alzheimer's dementia and Parkinson's dementia.Results A total of 48 trials encompassing 22,845 patients were included in our analysis. Anorexia was the most commonly reported psychiatric adverse event, followed by agitation, insomnia, and depression. Individuals exposed to AChEIs had a greater risk of experiencing appetite disorders, insomnia, or depression compared with those who received placebo (anorexia: odds ratio [OR] 2.93, 95% confidence interval [CI] 2.29-3.75; p < 0.00001; decreased appetite: OR 1.93, 95% CI 1.33-2.82; p = 0.0006; insomnia: OR 1.55, 95% CI 1.25-1.93; p < 0.0001; and depression: OR 1.59, 95% CI 1.23-2.06, p = 0.0004). Appetite disorders were also more frequent with high-dose versus low-dose therapy. A subgroup analysis revealed that the risk of insomnia was higher for donepezil than for galantamine.Conclusions Our findings suggest that AChEI therapy may negatively impact psychological health, and careful monitoring of new psychiatric symptoms is warranted. Lowering the dose may resolve some psychiatric adverse events, as may switching to galantamine in the case of insomnia.

In the context of the high risk of airborne transmission of COVID-19, the question of the production of particles while playing wind instruments is highly relevant. Therefore, in this study, 23 professional musicians played their instruments in a cleanroom in cleanroom-grade clothing. The most common orchestral wind instruments flute, oboe, clarinet, and trumpet were therefore chosen. Aerosol measurements using a laser particle counter were conducted to quantify the emission rate of respiratory particles. Orchestral excerpts as well as sustained tones in two dynamic levels were played. The emitted particles were mostly in a submicron size range. For all instruments besides the clarinet, an influence of the loudness of playing on the emission rate could be observed. The emission rates for all musical instruments were independent of the passages played. Flute and oboe showed similar emission rates but lower than the values for clarinet and trumpet. While playing a note with a small volume, the flute, oboe, and trumpet have a similar emission rate as found for speaking.

The temporal discrimination threshold (TDT) has been established as a biomarker of impaired temporal processing and endophenotype in various forms of focal dystonia patients, such as cervical dystonia, writer's cramp or blepharospasm. The role of TDT in musician's dystonia (MD) in contrast is less clear with preceding studies reporting inconclusive results. We therefore compared TDT between MD patients, healthy musicians and non-musician controls using a previously described visual, tactile, and visual-tactile paradigm. Additionally, we compared TDT of the dystonic and non-dystonic hand and fingers in MD patients and further characterized the biomarker regarding its potential influencing factors, i.e. musical activity, disease variables, and personality profiles. Repeated measures ANOVA and additional Bayesian analyses revealed lower TDT in healthy musicians compared to non-musicians. However, TDTs in MD patients did not differ from both healthy musicians and non-musicians, although pairwise Bayesian t-tests indicated weak evidence for group differences in both comparisons. Analyses of dystonic and non-dystonic hands and fingers revealed no differences. While in healthy musicians, age of first instrumental practice negatively correlated with visual-tactile TDTs, TDTs in MD patients did not correlate with measures of musical activity, disease variables or personality profiles. In conclusion, TDTs in MD patients cannot reliably be distinguished from healthy musicians and non-musicians and are neither influenced by dystonic manifestation, musical activity, disease variables nor personality profiles. Unlike other isolated focal dystonias, TDT seems not to be a reliable biomarker in MD.

Music can act as a mnemonic device that can elicit multiple memories. How musical and non-musical information integrate into complex cross-modal memory representations has however rarely been investigated. Here, we studied the ability of human subjects to associate visual objects with melodies. Musical laypersons and professional musicians performed an associative inference task that tested the ability to form and memorize paired associations between objects and melodies ("direct trials") and to integrate these pairs into more complex representations where melodies are linked with two objects across trials ("indirect trials"). We further investigated whether and how musical expertise modulates these two processes. We analyzed accuracy and reaction times (RTs) of direct and indirect trials in both groups. We reasoned that the musical and cross-modal memory demands of musicianship might modulate performance in the task and might thus reveal mechanisms that underlie the association and integration of visual information with musical information. Although musicians showed a higher overall memory accuracy, non-musicians' accuracy was well above chance level in both trial types, thus indicating a significant ability to associate and integrate musical with visual information even in musically untrained subjects. However, non-musicians showed shorter RTs in indirect compared to direct trials, whereas the reverse pattern was found in musicians. Moreover, accuracy of direct and indirect trials correlated significantly in musicians but not in non-musicians. Consistent with previous accounts of visual associative memory, we interpret these findings as suggestive of at least two complimentary mechanisms that contribute to visual-melodic memory integration. (I) A default mechanism that mainly operates at encoding of complex visual-melodic associations and that works with surprising efficacy even in musically untrained subjects. (II) A retrieval-based mechanism that critically depends on an expert ability to maintain and discriminate visual-melodic associations across extended memory delays. Future studies may investigate how these mechanisms contribute to the everyday experience of music-evoked memories.

Musicians suffering from music performance anxiety (MPA) fear and/or avoid performing situations. While performing, they often experience physiological (like increased heart rate or sweating), cognitive (for example fear of control loss), behavioral (like making mistakes or avoiding performances) and emotional symptoms (mostly fear) leading to high distress. About a quarter of all professional musicians suffer from MPA. In studies, cognitive behavioral therapy and beta blockers were effective options for treating MPA. Other treatments and preventive methods are presented.

Background: Nonspecific chronic neck pain (cNP) is common in adult violinists and violists and is often treated with osteopathic medicine (OM), although the effectiveness of this treatment has not been determined to date. This study aimed to evaluate the effectiveness and safety of OM in adult violinists and violists with cNP. Methods: In a two-armed randomized controlled single-center open trial, adult violinists and violists, including music students, with cNP (⩾12 weeks) were randomized to either five individualized OM sessions (OM group) or to no intervention (control group, CG) in the outpatient clinic for integrative medicine, Charité - Universitätsmedizin Berlin, Germany. All patients received a musicians’ medicine consultation and paracetamol on demand. The primary outcome parameter was the neck pain intensity on a visual analog scale (VAS, 0–100 mm, 0 = no pain, 100 = worst imaginable pain) after 12 weeks. Secondary outcomes included neck pain disability (Neck Disability Index, NDI, 0–100%) after 12 weeks. The last follow-up visit was after 52 weeks. Statistical analysis included analysis of covariance adjusted for respective baseline value. Results: Altogether, 62 outpatients were included [OM group ( n = 28), CG ( n = 34); 81% female; mean age, 41.6 ± 11.1 years; mean baseline neck pain, 55.9 ± 11.6 mm]. After 12 weeks, OM was associated with an improvement in the OM group versus the CG in neck pain on the VAS [14.6 mm (95% confidence interval 8.0; 21.2) versus 40.8 mm (34.7; 46.9), p < 0.001, Cohen’s d = 1.4], and neck pain disability as determined by the NDI [8.8% (6.7; 10.8) versus 17.2% (15.3; 19.1), p < 0.001]. Some improvements were maintained until 52 weeks of follow-up. No serious adverse events were observed. Conclusions: The results of this study suggest that OM might be effective in reducing pain intensity in adult violinists and violists with nonspecific cNP. Further studies should investigate the efficacy of OM in comparison with a sham procedure and with other effective therapy methods in high-quality multicenter trials. Trial registration: WHO Trial Registration https://apps.who.int/trialsearch/NoAccess.aspx?aspxerrorpath=/trialsearch/Trial2.aspx by German Clinical Trials Register DRKS00009258, Universal Trial Number (UTN): U1111-1173-5943.

Free AccessNeuropsychologie und MusikAlexander SchmidtAlexander SchmidtBerliner Centrum für Musikermedizin, Charité – Universitätsmedizin BerlinKurt-Singer-Institut für Musikphysiologie und Musikergesundheit, Hochschule für Musik Hanns Eisler BerlinSearch for more papers by this authorPublished Online:June 26, 2020https://doi.org/10.1024/1016-264X/a000296PDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInRedditE-Mail SectionsMoreMusik kann in vielfältiger Weise physiologische und psychische Prozesse im zentralen Nervensystem beeinflussen. So führt zum Beispiel das intensive Spielen eines Musikinstruments zu neuroplastischen Anpassungen im Gehirn mit Veränderungen sowohl der Hirnstruktur wie auch der Hirnfunktion (Münte, Altenmüller & Jäncke, 2002). Die Stimmung kann durch aktives Musizieren oder das Hören von Musik unmittelbar beeinflusst werden und Musik ist einer der stärksten Auslöser für Emotionen (Koelsch, 2014).In den letzten Jahren sind daher auf Musik basierende Behandlungs- und Rehabilitationsprogramme bei Erkrankungen des zentralen Nervensystems von zunehmendem wissenschaftlichen Interesse. Zahlreiche Studien zeigen Verbesserungen von Kognition, motorischer Funktion oder emotionalem Wohlbefinden bei Patientinnen und Patienten mit Schlaganfall, Demenz oder der Parkinson Erkrankung durch aktives Musizieren oder das Hören von Musik (ein Überblick findet sich zum Beispiel bei Sihvonen et al., 2017 oder Grau-Sanchez, Münte, Altenmüller, Duarte & Rodriquez-Fornells, 2020).Das Spiel eines Musikinstruments auf professionellem Niveau gehört jedoch auch zu den anspruchsvollsten menschlichen Tätigkeiten mit höchsten Anforderungen an die zeitlich-räumliche Bewegungskoordination unter enger Bindung an Emotionen und strenger Kontrolle durch das Gehör. Vor diesem Hintergrund sind berufsspezifische Erkrankungen und insbesondere Erkrankungen des zentralen Nervensystems bei professionellen Musikerinnen und Musikern häufig (Fishbein, Middlestadt, Ottati, Straus & Ellis, 1988).In diesem Sonderheft werden verschiedene der oben erwähnten vielfältigen Interaktionen zwischen Musik und Gehirn detaillierter dargestellt.Wie musikalische Aktivität Struktur und Funktion von Gedächtnisarealen im Gehirn neuroplastisch beeinflusst ist Thema des Übersichtsartikels von Hoffmann et al. Dabei wird auch auf vielversprechende therapeutische Effekte des Musikhörens und aktiven Musizierens bei Patientinnen und Patienten mit Gedächtnisstörungen eingegangen.In der von Nager et al. vorgestellten Studie werden neuroplastische Adaptationsprozesse bei professionellen Musikerinnen und Musikern mittels Elektroenzephalogramm untersucht. Dabei sind Schlagzeugerinnen und Schlagzeuger im Vergleich zu anderen Musizierenden und Nichtmusizierenden aufgrund ihrer Tätigkeit besser in der Lage, zeitlich abweichende Stimuli zu erkennen.Im Übersichtsartikel von Holm et al. wird das bislang wenig untersuchte neuropsychologische Syndrom der musikalischen Anhedonie thematisiert. Betroffene sind dabei nicht in der Lage, Emotionen beim Musikhören zu empfinden. Die Störung ist von einer generellen Anhedonie, Depression oder Amusie abzugrenzen, kann nach fokaler Hirnschädigung auftreten und für Betroffene eine deutliche Einschränkung der Lebensqualität bedeuten.In weiteren Übersichtsarbeiten werden zwei der bedeutsamsten neuropsychiatrischen Musikererkrankungen vorgestellt. Der Artikel von Borngräber und Schmidt thematisiert die fokale Dystonie bei Musikerinnen und Musikern, eine schwer zu behandelnde, karrierelimitierende neurologische Bewegungsstörung, die etwa 1 bis 2 % der professionellen Musikerinnen und Musiker – vom Musiklehrer bis zur Konzertpianistin – betrifft. Neuropsychologische Aspekte spielen bei der Erkrankung eine wichtige Rolle. Aktuelle Erkenntnisse zur Phänomenologie, Pathophysiologie, Risikofaktoren und Behandlungsoptionen werden dargestellt.Die häufigste psychiatrische Musikererkrankung ist die Auftrittsangst, die durch sehr große Ängste vor Auftritten charakterisiert ist und etwa ein Viertel der professionellen Musikerinnen und Musiker betrifft. In der Übersichtsarbeit von Mumm et al. wird der aktuelle Forschungsstand zu klinischer Präsentation, Ursachen, Diagnostik, Therapie und Prävention der Erkrankung präsentiert sowie die Abgrenzung zum Phänomen des Lampenfiebers aufgezeigt.Vier der fünf vorgestellten Arbeiten sind am Berliner Centrum für Musikermedizin der Charité – Universitätsmedizin Berlin (www.musikermedizin.charite.de) entstanden – einem interdisziplinären Kompetenzzentrum, an dem schwerpunktmäßig erkrankte Musikerinnen und Musiker behandelt und die vielfältigen Wirkungen der Musik auf das Gehirn, Gesundheit und Krankheit wissenschaftlich untersucht werden.LiteraturFishbein, M., Middlestadt, S. E., Ottati, V., Straus, S. & Ellis, A. (1988). Medical problems among ICSOM musicians: Overview of a national survey. Medical Problems of Performing Artists, 3, 1–9. First citation in articleGoogle ScholarGrau-Sanchez, J., Münte, T. F., Altenmüller, E., Duarte, E. & Rodriquez-Fornells, A. (2020). Potential benefits of music playing in stroke upper limb motor rehabilitation. Neuroscience & Biobehavioral Reviews, 112, 585–599. First citation in articleCrossref, Google ScholarKoelsch, S. (2014). Brain correlates of music-evoked emotions. Nature Reviews Neuroscience, 15, 170–180. First citation in articleCrossref, Google ScholarMünte, T. F., Altenmüller, E. & Jäncke, L. (2002). The musician’s brain as a model of neuroplasticity. Nature Reviews Neuroscience, 3, 473–478. First citation in articleCrossref, Google ScholarSihvonen, A. J., Särkämö, T., Leo, V., Tervaniemi, M., Altenmüller, E. & Soinila, S. (2017). Music-based interventions in neurological rehabilitation. Lancet Neurology, 16, 648–660. First citation in articleCrossref, Google ScholarProf. Dr. med. Alexander Schmidt, Berliner Centrum für Musikermedizin, Charité – Universitätsmedizin Berlin, Luisenstr. 13, 10117 Berlin, Deutschland, E-Mail alexander.schmidt@charite.deFiguresReferencesRelatedDetails Volume 31Issue 2Juni 2020ISSN: 1016-264XeISSN: 1664-2902 Published online26. Juni 2020 InformationZeitschrift für Neuropsychologie (2020), 31, pp. 53-54 https://doi.org/10.1024/1016-264X/a000296.© 2020Hogrefe AGDanksagung: Alexander Schmidt wird vom Bundesministerium für Bildung und Forschung unterstützt (01PL16032).PDF download

Musical activity has been found to drive plasticity in brain areas involved in the process of playing a musical instrument. The present article reviews how musical activity influences the brain structures involved in memory and how it impacts on memory functioning memory functioning. Musical activity appears to be associated with better memory capacity across the lifespan. Importantly, training-induced effects are not restricted to childhood, but can occur even in the elderly population. We conclude by outlining how musical activity, both on the receptive and active level, can be beneficial to patients suffering from memory disorders, inducing brain plasticity and memory improvement.

Abstract. Musicians suffering from music performance anxiety (MPA) fear and/or avoid performing situations. While performing, they often experience physiological (like increased heart rate or sweating), cognitive (for example fear of control loss), behavioral (like making mistakes or avoiding performances) and emotional symptoms (mostly fear) leading to high distress. About a quarter of all professional musicians suffer from MPA. In studies, cognitive behavioral therapy and beta blockers were effective options for treating MPA. Other treatments and preventive methods are presented.

Music performance anxiety (MPA) is one of the most common disorders among professional musicians, nevertheless, little is known about the disease. With this systematic review, prevalence, risk factors and treatment procedures for MPA were assessed, and for the first time, quality assessments were carried out for all studies using standardized assessment tools. A systematic literature search was conducted via search algorithms in the databases MEDLINE, EMBASE, CINAHL, PsycArticles, PsycInfo and ERIC. Included were case reports, case-control, cohort, cross-sectional and intervention studies examining professional musicians with MPA. For quality assessment, adapted tools of the National Heart, Lung, and Blood Institute were used. A total of 43 studies were included (10 case reports, 21 intervention, 11 cross-sectional, one cohort study). Quality ratings ranged from -11 to 6 out of a maximum of 15/16 points for cross-sectional/cohort studies and -4 to 11 out of 18 points for intervention studies. The prevalence of MPA was between 16.5% and 60%. More women than men were affected and musicians older than 45-50 years reported less MPA than younger musicians. Regarding treatment cognitive behavioural therapy (CBT) and β-blockers were most often researched with beneficial results for CBT. However, studies with adequate control groups for CBT interventions are needed to clarify its efficacy. Studies showed methodological weaknesses, especially in the selection of participants, recording of influencing factors, blinding of interventions, randomization of participants and analysis of comorbidity. Recommendations for further research are made.

Musician's dystonia (MD) is a focal, task-specific neurological movement disorder that presents with loss of voluntary motor control when playing the instrument and affects up to 1-2% of professional musicians. The current pathophysiological understanding of MD is that of a network disease, involving the sensorimotor cortex, basal ganglia, cerebellum and the limbic system. Various extrinsic factors, e.g. high temporal and spatial sensorimotor constraints on the instrument or more than 10 000 hours of accumulated practice time, as well as intrinsic factors, e.g. high levels of anxiety and perfectionism, and even genetic factors have been identified to increase the risk to develop MD. From a neuropsychological point of view, two phenotypes of MD can be distinguished with high or low psychological stress, which should be taken into account to adapt the individual therapy. Treatment options for MD include medication with trihexyphenidyl, local injections of botulinum toxin A, retraining, ergonomic changes of the instrument, and in patients with high psychological stress also antidepressants and behavioral therapy.

Abstract. Some people, although they are perfectly healthy and happy, cannot enjoy music. These individuals have musical anhedonia, a condition which can be congenital or may occur after focal brain damage. To date, only a few cases of acquired musical anhedonia have been reported in the literature with lesions of the temporo-parietal cortex being particularly important. Even less literature exists on congenital musical anhedonia, in which impaired connectivity of temporal brain regions with the Nucleus accumbens is implicated. Nonetheless, there is no precise information on the prevalence, causes or exact localization of both congenital and acquired musical anhedonia. However, the frequent involvement of temporo-parietal brain regions in neurological disorders such as stroke suggest the possibility of a high prevalence of this disorder, which leads to a considerable reduction in the quality of life.

BACKGROUND: Professional musicians frequently suffer from musculoskeletal complaints and disorders (MCD), which can be treated by osteopathic manipulative treatment (OMT). The aim of this systematic review was to evaluate the effectiveness and efficacy of OMT in adult musicians. METHODS: A systematic literature search included the electronic databases PubMed/MEDLINE, Medpilot, EBSCOhost, BioMedCentral, OSTMED-Dr, osteopathic-research.com, PEDro, hand searches, and contact to European osteopathic academies. Interventional and observational studies published between January 1999 and January 2019, of professional or amateur musicians who were either healthy or had MCD treated by OMT, were included. The quality of the randomized controlled trials (RCTs) was assessed by the Physiotherapy Evidence Database (PEDro) Scale ranging between 0 and 10 points. RESULTS: Only 5 studies were identified investigating OMT in musicians, including 1 RCT (cross-over design), 3 clinical controlled trials, and 1 case report. The internal validity of the RCT was assessed as 6 points. OMT was reported to have a positive impact on healthy singers, improving phonation time, voice quality, and voice range. It also improved the cervical range of motion in violinists. No adverse events were observed, although only the cross-over RCT reported partly an assessment of adverse events. CONCLUSIONS: The evidence for OMT in adult musicians is very limited. Prospective controlled clinical trials investigating OMT in musicians are required.