Enhanced P1-N1 auditory evoked potential in patients with musicians' cramp

Auditory evoked potentials (AEPs) were examined in patients with musician's cramp (focal dystonia) in order to determine whether these patients have electrophysiological changes in a sensory system that is not usually associated with symptoms. All participants were professional guitarists and were required to listen to 2,000 monaurally presented stimuli (middle C, with duration of 7 ms). During one block, 250 stimuli were presented to one ear. Once a block was finished, another block was presented in the other ear; in total there were eight blocks of stimuli. During this task, EEGs from 10 scalp electrodes and one bipolar eye channel were continuously recorded. There were no significant latency or topographical differences in the electrophysiological recordings. However, there was a significant group difference in the peak-to-peak amplitude of the P1-N1a component. The patients had a larger peak-to-peak difference than controls (1.63 vs. 0.62 microV). The P1 and N1a are cortically generated potentials. Patients with focal dystonia had an increase in activity compared to controls when processing simple auditory stimuli. Such changes in electrophysiological responses may be a result of increases in excitation or lack of inhibition; alternatively the changes may represent cross-modal maladaptive plasticity from the somatosensory modality to the auditory modality. Thus, this study provides further evidence that patients with focal dystonia have alterations of the central nervous system that are not limited to their symptomatic sensory domain.