Investigation of SSRI-induced neuroplastic changes in musicians using functional magnetic resonance imaging (fMRI)

This study is being conducted as part of a cooperation between the mdw - University of Music and Performing Arts Vienna and the University Department of Child and Adolescent Psychiatry and the University Department of Psychiatry and Psychotherapy at the Medical University of Vienna.

Focal dystonia is one of the most serious work-related disorders in musicians and affects about 1% of all professional pianists. Functional and structural changes in the brain play an important role both in learning an instrument and in the pathophysiology of focal dystonia (maladaptive neuroplasticity). The neurotransmitter serotonin in particular plays an important role here. While previous forms of treatment primarily pursue a symptomatic approach, retraining offers the possibility of overcoming maladaptive neuroplastic changes. The treatment with selective serotonin reuptake inhibitors (SSRIs) increases the concentration of serotonin in the synaptic cleft, which can trigger neuroplastic changes.

In this randomised, placebo-controlled, double-blind fMRI study, 60 pianists suffering from focal dystonia will be examined. After inclusion in the study, the patients are randomly divided into three groups. While group 1 is treated exclusively with retraining for 6 months, groups 2 and 3 additionally receive either placebo or the SSRI escitalopram. In each case, before and after the treatment, a measurement is made with the most modern imaging methods (3 Tesla fMRI), which allow structural and functional changes in the brain to be depicted. In addition, a pilot study will be conducted on 20 healthy control subjects to investigate the influence of SSRIs on neuroplastic changes when learning an instrument.

Contact: stegemann@mdw.ac.at