🎼 Neural Plasticity Following Stereotactic Brain Surgery in a Musician with Focal Dystonia
🧠 Background
A 55-year-old professional pianist with focal hand dystonia underwent stereotactic lesioning surgery.
Postoperatively, digital extension was lost, rendering instrumental performance nearly impossible.
The irreversible focal lesion disrupted pre-existing compensatory motor strategies and sensorimotor control that had developed over decades of adaptive playing.
🎹 Observations
In the early postoperative phase, a marked desynchronization of auditory-motor coupling and degradation of motor representation were observed.
Over the following six years (age 55–61), gradual functional improvement was achieved through repeated musical task rehearsal, tactile stimulation, and auditory imagery training.
This process reflected not regeneration within the lesioned site, but rather compensatory reorganization involving adjacent cortical regions and the contralateral hemisphere.
🧩 Interpretation
Functional recovery was partial yet significant, supported by the establishment of novel synaptic connectivity that rerouted sensory input toward motor output through alternate neural pathways.
Importantly, this recovery is considered to have required a phase of motor practice-based rehabilitation prior to the re- coupling of auditory imagery and kinesthetic feedback.
🎵 Conclusion
This case demonstrates that adult synaptic reorganization can occur following focal brain injury when guided by meaningful musical contexts.
Such recovery represents music-induced neuroplasticity, suggesting that the auditory system can facilitate compensatory learning even in later adulthood.
This finding highlights the therapeutic effiacy of rehabilitation for musicians with task-specific dystonia following neurosurgical intervention.
📘 Supplementary Video Materials
🎹 1. Before Surgery
Piano performance prior to surgery.
Demonstrates motor compensation under focal hand dystonia before thalamic intervention.
🎵 2. Postoperative Sequelae
Persistent motor impairment after VO-thalamotomy.
Shows the loss of finger extension and altered motor control following stereotactic ventro-oral thalamotomy.
🌱 3. Five Years After Surgery (same piece as ①)
Performance five years post-surgery.
Illustrates partial recovery of musical execution through compensatory neural reorganization and motor adaptation.
✍️ Author
Motoko Ino
Independent Researcher / Pianist (Japan)
📧 Contact: fuguehelix@au.com
PC : fugahelix@zc.ztv.ne.jp
