The Neurology of String Instrument Performance

In The Neurology of String Instrument Performance: A Practical Guide for Clinicians, Teachers and Performers, a noted neurologist-researcher and classically trained string instrumentalist offers the first in-depth and comprehensive overview of the field, including detailed, practical advice for string injury prevention and management. With the explosive advances in neurological measurement and imaging technologies in the last decade, research on the interplay between science and music has expanded dramatically. One of these subfields, the neurology of music, has grown significantly in recent years, and the field of string instrumental performance is now benefitting extensively from this burgeoning neurological research and scholarship. As a result, the standard of clinical care for tens of thousands of string instrument performers worldwide is rising steadily. The neurology of string instrument performance is vibrant because the creation of music uses so many of the neurological structures, engaging many different areas of the body. From a research and clinical standpoint, there are many questions to consider: For example, do serious medical problems in string performers arise from incorrect performing habits? This is just one of the central and vitally important topics for medical professionals caring for these patients-without correction of an offending posture or technique, patients may recover from their problem only to have it recur. Adding significant value to this unique title is access to fascinating online video material that provides a range of vignettes of selected clinical cases. Disorders in string instrument performers demonstrated and discussed include task-specific tremor, focal dystonia, Parkinson's disease, essential tremor, enhanced physiologic tremor, focal atrophy, and others. The online video material also includes illustrations of the parameters of normal playing on violin, viola and violoncello. The title is structured in three major parts: Part 1 -- Basic Mechanics, Part 2 - Clinical Cases, and Part 3 - The Neurology of Musical Performance. Thus the book begins with a review of the background of string instrument instruction, the motor demands of the instruments, the emerging literature on the biomechanics of string instrument performance, and current thoughts on musical pedagogy. The book includes the controversies surrounding the nature vs. nurture arguments, reviews other "experiments of nature" that impact musical processing (absolute pitch, synaesthesia, William's syndrome, savants), reviews neuroimaging and neurophysiologic studies of the development of cortical plasticity and musical exposure, and discusses several historical examples of musical prodigies. This volume also answers important questions of string instrument performance and motor control of the hand, including: How did the hand develop? What evolutionary forces determined its present development and structure? How do these characteristics help or hinder the mechanical requirements of string instrument performance? The neurology of the human hand is reviewed, with background dating back to Charles Bell, Darwin, and Gowers, and to modern anthropological studies, including Napier and others. Modern hand structure is related to current demands of instrumental performance. Finally the book also investigates how the motor system learns and the role of imitation or observation in motor learning. The powerful discovery of the mirror neuron system is reviewed, and the benefits and limitations of learning by action observation are covered. Functional imaging studies of action observation and learning are reviewed. The implications of these findings are related to Suzuki instruction and to other modern techniques of early childhood learning. Focal task-specific dystonia of the musician's hand is one of the most unusual and intriguing disorders in neurology. The clinical phenotype of focal dystonia in string players is reviewed, along with recent neuroimaging and genetic studies that inform our understanding of this unusual disorder or motor control. Comprehensive and engagingly written, The Neurology of String Instrument Performance: A Practical Guide for Clinicians, Teachers and Performers is a ground-breaking contribution to the field and an indispensable guide for all physicians, researchers, teachers, and performers interested in the neurological background and clinical concerns surrounding string performance.