Intact finger representation within primary sensorimotor cortex of Musician’s Dystonia

Musician’s dystonia presents with a persistent deterioration of motor control during musical performance. A predominant hypothesis has been that this is underpinned by maladaptive neural changes to the somatotopic organisation of finger representations within primary somatosensory cortex. Here, we tested this hypothesis by investigating the finger-specific activity patterns in the primary somatosensory and motor cortex using functional MRI in nine musicians with dystonia and nine healthy musicians. A purpose-built keyboard device allowed functional MRI characterisation of activity patterns elicited during passive extension and active finger presses of individual fingers. We analysed the data using both traditional spatial analysis and state-of-the art multivariate analyses. Our analysis reveals that digit representations in musicians were poorly captured by spatial measures. An optimised spatial metric found clear somatotopy but no difference in the spatial geometry between fingers. Representational similarity analysis was confirmed as a highly reliable technique and more consistent than all spatial metrics evaluated. Significantly, the dissimilarity architecture was equivalent for musicians with and without dystonia and no expansion or spatial shift of digit representation maps were found in the symptomatic group. Our results therefore suggest that the neural representation of generic finger maps in primary sensorimotor cortex is intact in Musician’s dystonia. These results are against the idea that task-specific dystonia is associated with a distorted hand somatotopy and suggests that task-specific dystonia is due to a higher order disruption of skill encoding. Such a formulation can better explain the task-specific deficit and offers mechanistic insight for therapeutic interventions.