Peripheral nerve injuries in the performing artist.

Dancers and musicians have unique physical demands that can lead to injury of the peripheral nerves. Specific dance movements and specific instrument positions, combined with countless hours of practice and repetition, create an environment for potential nerve injury. Familiarity with these variables and recognition of the common presentations of neuropathic syndromes are essential in the evaluation of a performing artist with a suspected peripheral nerve injury. Assessment should include an understanding and analysis of their dance style or instrument playing posture, particularly in the position or motion that recreates the symptoms if possible. Practice and performance schedules should also be considered. Diagnosis may require electrodiagnostic testing, imaging, or diagnostic injections. Treatment should be comprehensive and may include modifications in practice schedule, posture/position, and technique in addition to consideration of medications, splints/orthoses, physical therapy, and injections. The instructor/teacher should be involved in the treatment plan if applicable. Complete rest in this population may not be realistic or necessary. Early and accurate diagnosis of nerve injury is important for safe return to dance or instrumental music.

Quality of Life Measures in Young Pre-Professional Dancers Compared to Non-Athletes and Non-Dancer Athletes.

Aim: To investigate quality of life (QoL) measures in a cohort of young female dancers. Methods: Cross-sectional survey study design was utilized to study dancers 8 to 17 years enrolled in two elite dance schools in the Boston area. The main outcome measure was the Pediatric Quality of Life (PedsQL 4.0) questionnaire, a validated QoL survey for children, with established normative values for comparison. Demographics and questions pertaining to training regimens and injury/illness history were also included. Sub-groups (8-11 years, 12-14 years, and 15-17 years) were created to analyze outcomes by age. Results: One hundred and forty emails were delivered, 72 were completed and included in the final data analysis (51.4%). The median scores for physical, psychosocial, emotional, social, and school PedsQL sub-scales were 87.5, 90.0, 80.0, 100.0, and 92.5, respectively. The median score of the total PedsQL scores was 88.8. No difference in QoL outcomes by age group was found (physical: P = .328; psychosocial: P = .918; emotional: P = .673; social: P = .573; school: P = 0.962; total: P = 0.766). 52.5% of the participants responded that they regularly perform in shows. Median hours/week of dance rehearsal was 10 hours (mean ± standard deviation: 10.3 ± 4.9; 95% CI: 9.0, 11.6; IQR: 7.0, 13.5; range: 2.0, 20.0) and 68.9% reported they practice and rehearse throughout the entire calendar year as opposed to solely during the school year; most dancers reported participating in dance 11 months (median value) per year (mean ± standard deviation: 10.7 ± 0.8; 95% CI: 10.5, 11.0; IQR: 10.0, 11.0; range: 9.0, 12.0). Conclusion: QoL measures for young female dancers were higher relative to existing data for the general population and lower compared to other sports participation. These results will support the social, emotional, and physical health of young dancers.

Efficacy of Digital Dance on Brain Imagery, Cognition, and Health: Randomized Controlled Trial.

BACKGROUND: Multidomain interventions have demonstrable benefits for promoting healthy aging, but self-empowerment strategies to sustain long-term gains remain elusive. OBJECTIVE: This study evaluated the effects of digital somatosensory dance game participation on brain imagery changes as primary outcomes and other physical and mental health measures as secondary outcomes related to healthy aging. METHODS: Between August 31, 2020, and June 27, 2021, this randomized controlled trial recruited 60 eligible participants older than 55 years with no recent engagement in digital dance games. A computer-generated randomization sequence was used to allocate participants 1:1, without stratification, to an intervention group (n=30) who underwent digital somatosensory dance game training or a control group (n=30). An anonymized code masked the intervention allocations from the investigators, and individuals who assigned the interventions were not involved in analyzing the study data. The intervention entailed two 30-minute dance game sessions per week for 6 months, and the control group received healthy aging education. Primary outcomes were brain imagery changes. All variables were measured at baseline and the 6-month follow-up, and intervention effects were estimated using t tests with intention-to-treat analyses. RESULTS: Compared with the control group, intervention participants had significantly different brain imagery in the gray matter volume (GMV) of the left putamen (estimate 0.016, 95% CI 0.008 to 0.024; P<.001), GMV of the left pallidum (estimate 0.02, 95% CI 0.006 to 0.034; P=.004), and fractional amplitude of low frequency fluctuations of the left pallidum (estimate 0.262, 95% CI 0.084 to 0.439; P=.004). Additionally, the intervention group had different imagery in the cerebellum VI GMV (estimate 0.011, 95% CI 0.003 to 0.02; P=.01). The intervention group also had improved total Montreal Cognitive Assessment scores (estimate 1.2, 95% CI 0.27 to -2.13; P<.01), quality of life (estimate 7.08, 95% CI 2.35 to 11.82; P=.004), and time spent sitting on weekdays (estimate -1.96, 95% CI -3.33 to -0.60; P=.005). Furthermore, dance performance was significantly associated with cognitive performance (P=.003), health status (P=.14), resilience (P=.007), and demoralization (P<.001). CONCLUSIONS: Digital somatosensory dance game participation for 6 months was associated with brain imagery changes in multiple regions involving somatosensory, motor, visual, and attention functions, which were consistent with phenotypic improvements associated with healthy aging. TRIAL REGISTRATION: ClinicalTrials.gov NCT05411042; https://clinicaltrials.gov/study/NCT05411042.

An intriguing case of abdominal pain-Belly dancer's syndrome.

Belly dancer dyskinesia, a rare disease, may often be overlooked as a regular nonspecific abdominal pain, and therefore, high index of clinical suspicion is required to avert misdiagnosis.

Unraveling belly dancer's dyskinesia and other puzzling diagnostic contortions: A narrative literature review.

Belly dancer's dyskinesia (BDD) is characterized by involuntary abdominal wall movements that are rhythmic, repetitive, and dyskinetic. The present study aims to review BDD's etiology, pathophysiology, and management. We searched six databases to locate existing reports on BDD published from 1990 to October 2023 in electronic form. A total of 47 articles containing 59 cases were found. The majority of the patients affected by BDD were female, accounting for 61.01% (36/59) of the cases. The mean and median ages were 49.8 (standard deviation: 21.85) and 52 years (range: 7-85), respectively. The BDD was unilateral in only 3.38% (2/59). The most commonly reported causes associated with BDD were 17 idiopathic, 11 drug-induced, 11 postsurgical procedures, 5 pregnancies, and 4 Vitamin B12 deficiencies. BDD is a diagnosis of exclusion, and other more common pathologies with similar presentation should be ruled out initially. Differential diagnostic reasoning should include diaphragmatic myoclonus, cardiac conditions, truncal dystonia, abdominal motor seizures, propriospinal myoclonus, and functional or psychiatric disorders.

The vertical mobility of the first tarsometatarsal joint during demi-plié with forced turnout in ballet dancers.

The forced turnout has a perceived risk of development of hallux valgus (HV) in ballet dancers. We determined how the forced turnout affects the sagittal mobility of the first tarsometatarsal (TMT) joint, which is one of the pathogenic factors of HV development. Seventeen female ballet dancers (body mass index: 18.2 ± 1.8 kg/m2) were included and performed demi-plié in control, functional turnout, and forced turnout conditions. Ultrasound imaging synchronized with a three-dimensional motion analysis system was used for measuring the vertical locations of the first metatarsal and medial cuneiform (MC) to evaluate the first TMT joint mobility. Plantar displacement of MC and the first TMT joint mobility in the forced turnout were the greatest among the 3 conditions. Multiple regression analysis indicated that the greater extent of the forcing angle might increase the displacement of MC and the first TMT joint mobility. Evaluating the sagittal mobility of the first TMT joint in the forced turnout can assist in understanding the association between inappropriate techniques including the forced turnout and HV development in ballet dancers. Since the excessive mobility of the first TMT joint is a factor in HV development, the acquirement of adequate active turnout may have the potential to prevent HV development in ballet dancers.

Exploring the experiences of dancers who have achieved peak performance: on-stage, pre-stage, and post-stage.

The aim of this study is to identify and classify the different attributes that contribute to peak performance among professional dancers, and to understand how these attributes change over time. We conducted an analysis using inductive content analysis on open-ended survey data collected from 42 formally trained professional dancers. Additionally, we analyzed interview data from seven professional dancers who demonstrated outstanding achievements in the field among the survey participants. The main themes that emerged were related to various temporal events of peak performance experience: pre-stage, on-stage, and post-stage. During the on-stage, peak performance was perceived by both internal and external factors. During the pre-stage, emphasis was placed on technical, cognitive, and artistic strategies during practice, whereas just before going on the stage, attention shifted to psychological and physical strategies. During the post-stage, dancers reported immediate changes in their psychological and physical states following the peak performance experience, and thereafter, the peak performance experience was noted to influence psychological, technical, and cognitive aspects. These findings provide valuable insights into the key characteristics that emerge throughout a series of peak performance experiences and are consistent with previous research.

6-week time-restricted eating improves body composition, maintains exercise performance, without exacerbating eating disorder in female DanceSport dancers.

BACKGROUND: Despite the high risk of eating disorder (ED)-related attitudes and behaviors among female dancers, targeted scientific dietary regimens are currently inadequate. Time-restricted eating (TRE), a popular intermittent fasting protocol, has been shown to be effective in enhancing body composition and exercise performance in athletes. In this study, TRE was employed as a dietary regimen to improve body composition and exercise performance and address ED attitudes and behaviors in DanceSport dancers. METHODS: Twenty female DanceSport dancers were recruited and divided into two groups: TRE (n = 10) and normal diet (ND) (n = 10). The TRE group consumed their self-selected necessary energy intake exclusively between 11 a.m. and 7 p.m. (utilizing a 16-hour fasting and 8-hour eating window) for 6 weeks, while the ND group maintained their regular dieting patterns. The consumption of water, black tea, or coffee without added sugar or milk was not restricted. Physical activity and calorie intake were systematically recorded during the TRE intervention. Body composition, aerobic and anaerobic performance, and ED attitudes and behaviors were assessed before and after the TRE intervention. The trial was registered in the Chinese Clinical Trial Registry under the identifier ChiCTR2200063780. RESULTS: The fixed effects tests (p < 0.0001) and estimates for the intercept (p < 0.0001) of hunger level indicated a noticeable effect on the initial state of hunger during TRE. No significant differences were observed in ED attitudes or behaviors (p > 0.05). TRE resulted in a reduction in hip circumference (p = 0.039), fat mass (kg) (p = 0.0004), and body fat percentage (p = 0.0005), with no significant decrease in fat-free mass (p > 0.05). No significant improvement was observed in aerobic performance (p > 0.05). The average power (AP) (p = 0.01) and AP/Body weight ratio (p = 0.003) significantly increased. Additionally, the power drop decreased significantly (p = 0.019). Group-by-time interactions were observed for fat mass (kg) (p = 0.01), body fat percentage (p = 0.035), and AP/Body weight (p = 0.020). CONCLUSION: TRE can be considered a feasible nutritional strategy for DanceSport dancers, facilitating improvements in body composition without compromising aerobic and anaerobic exercise performance or exacerbating ED attitudes and behaviors. Moreover, TRE may facilitate more favorable physiological adaptations, potentially contributing to improved exercise performance.

Embodied metacognition as strengthened functional connection between neural correlates of metacognition and dance in dancers: exploring creativity implications.

Introduction: Dance education fosters embodied metacognition, enhancing student's creativity. This study examines the crucial role of functional connectivity (FC) between the neural correlates of metacognition (NCM) and dance (NCD) as the neurological foundation for dancers' embodied metacognition. The investigation also explores whether these consolidated FCs inform the general creativity in dancers. Methods: The research involved 29 dancers and 28 non-dancer controls. The study examined resting-state connections of the NCM through seed-based FC analysis. Correlation analyses were employed to investigate the connections between the targeted NCM-NCD FCs, initiated from the a priori NCM seed, and general creativity. Results: Dancers demonstrated heightened FC between NCM and NCD compared to non-dancer controls. The targeted regions included the putamen, globus pallidus, posterior cerebellum, and anterior insula of NCD. The dancers exhibited higher originality scores. In dancers, the enhanced FC showed a negative correlation with originality and a positive correlation with flexibility. Conversely, the controls exhibited no significant correlations. Discussion: Extended dance training enhances the NCM-NCD connection signifying embodied metacognition. This interconnectedness may serve as the neural predisposition for fostering general creativity performance in dancers. Dancers with heightened levels of originality could leverage the relatively weaker NCM-NCD FCs to facilitate better integration and coordination of creative cognitive processes. Our findings suggest that the consolidated functional connections as sculpted by domain-specific training may inform general creativity.

Musculoskeletal Morphology and Joint Flexibility-Associated Functional Characteristics across Three Time Points during the Menstrual Cycle in Female Contemporary Dancers.

Findings are inconsistent with regards to whether menstrual cycle phase-associated changes in physical functioning exist. It is possible that such discrepancies are due to varying rigour in experimental approaches. The current study aimed to systematically evaluate any effect of carefully tracked menstrual cycle phase on precisely measured muscle structure and function in a physically active group (contemporary dancers). Eleven women aged (M [SD]) 23.5 [2.94] years, undergoing 10.5 [1.73] hours of contemporary dance practice and 6.12 [2.36] hours of other physical activity per week, were recruited. Sex hormone level (enzyme-linked immunosorbent assays (ELISA), skin temperature and ovulation kits), physical pain assessments (Ice Water Test, Visual Analogue Scale, The Physical Activity Readiness Questionnaire, Self-Estimated Functional Inability Because of Pain Questionnaire, and Pain Anxiety Symptoms Scale), muscle architecture measurement (B-mode ultrasonography), and physical functioning (dynamometry, force-platform and electromyography) on both lower limbs were measured at three time points during one cycle, following three months of menstrual cycle monitoring. There was no difference in musculoskeletal flexibility variables between follicular, ovulatory, or luteal phases. Nonetheless, oestrogen change was associated with variability in 11 musculoskeletal variables, progesterone change was associated with variability in 7, and relaxin change was associated with variability in 15. Negative correlations existed between progesterone and flexibility and between oestrogen and jump variables. Moreover, oestrogen and relaxin were associated with increased musculoskeletal compliance, whilst progesterone was associated with increased muscle stiffness. In short, in absolute sex hormone levels, 'inter-individual' variances appear more impactful than 'intra-individual' variances. Not only are oestrogen and progesterone associated with differing musculoskeletal outcomes, but relaxin is also associated with musculoskeletal compliance changes. These effects are anticipated to impact jump height and flexibility, and hence, they could be expected to affect overall physical performance, including dance.

Surgical management of spiral oblique fractures of the fifth metatarsal leads to faster return to play in athletes: A systematic review.

PURPOSE: The purpose of this systematic review was to evaluate outcomes following both operative and nonoperative management of spiral oblique fractures of the fifth metatarsal. METHODS: During November 2023, the PubMed, Embase and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following operative and nonoperative management of dancer's fractures. Data regarding subjective clinical outcomes, radiological outcomes, complications and failure rates were extracted and analysed. RESULTS: Ten studies were included in this review. In total, 125 patients underwent operative treatment for dancer's fractures and 365 patients underwent nonoperative treatment for dancer's fractures. The weighted mean follow-up in the operative cohort was 15.3 ± 32.7 months and the weighted mean follow-up in the nonoperative cohort was 30.6 ± 24.3 months. The overall union rate in the operative cohort was 99.2% and the overall union rate in the nonoperative cohort was 98.6%. The weighted mean time to return to sport was 15.4 ± 6.7 and 22.4 ± 4.4 weeks in the operative cohort and nonoperative cohort, respectively. The complication rate in the operative cohort and nonoperative cohort was 12.0% and 15.1%, respectively. CONCLUSION: This current systematic review demonstrated comparable radiographic outcomes together with low failure rate and low complication rate following both operative and nonoperative management of dancer's fracture at short-term follow-up. However, faster return to sport rates was observed in the operative cohort, suggesting that surgical management of displaced spiral oblique fractures of the fifth metatarsal should be the mainstay treatment option. However, the under-reporting of data, marked heterogeneity between studies and paucity of comparative studies limits the generation of any robust conclusions; thus, further high-quality comparative studies are warranted. LEVEL OF EVIDENCE: Level IV.

Differences in Achilles tendon mechanical properties between professional ballet dancers and collegiate athletes utilizing shear wave elastography.

PURPOSE: To report normative stiffness parameters obtained using shear wave elastography in dorsiflexion from the Achilles tendons in asymptomatic professional ballet dancers and compare them with college-level athletes. METHODS: An Institutional Review Board (IRB)-approved study consists of 28 professional ballet dancers and 64 asymptomatic collegiate athletes. The athletes were further subdivided into runner and non-runner disciplines. Shear wave elastography (SWE) measurements were made in maximum ankle dorsiflexion position. RESULTS AND DISCUSSION: Forty-eight (52%) males and 44 (48%) females were examined with an overall mean age of 22.2 (± 3.8 years). There were no significant SWE differences between dominant and non-dominant legs in both groups and comparing spin vs. non-spin leg of ballet dancers (p > 0.05). Ballet dancers had significantly higher short-axis velocity values than runners and non-runners (2.34 m/s increase and 2.79 m/s increase, respectively, p < 0.001). Long-axis velocity was significantly higher in ballet dancers compared to non-runners (by 0.80 m/s, p < 0.001), but was not different between ballet dancers and runners (p > 0.05). Short-axis modulus was significantly higher in dancers compared to runners and non-runners (by 135.2 kPa and 159.2 kPa, respectively, p < 0.001). Long-axis modulus (LAM) was not significantly different in ballet dancers when compared to runners. CONCLUSION: Asymptomatic professional ballet dancers exhibit greater short-axis tendon stiffness compared to athletes and greater long-axis tendon stiffness compared to non-runners but similar to runners. The functional benefit from elevated short-axis stiffness in dancers is not clear but may be related to greater axial loading and adaptations of the tendon matrix.

Low Body Fat Percentage and Menstrual Cycle Disorders in Female Elite Adolescent Dancers.

Introduction: The menstrual cycle is an important indicator of health in female athletes. Female elite adolescent dancers are expected to control their weight while also training intensely, which can lead to menstrual disorders. This study aimed to investigate the relationship between body composition and menstrual status in female elite adolescent dancers. Methods: In total, 131 female elite adolescent dancers (age: 15.9 ± 1.5 years) were enrolled in this study. We measured the height, weight, and body fat percentage (BFP) for each participant and calculated their body mass index (BMI). We gathered information on individual menstruation patterns and the participants' menstrual cycles over the previous year using recall methods. We then compared the differences between dancers with menstrual cycle disorders and those without. Primary amenorrhea was defined as menarche occurring after the age of 15, while secondary amenorrhe was defined as experiencing fewer than 5 or no menstrual periods for at least 3 of the previous 12 months. We conducted a reliability test using the same questionnaire 2 weeks later. Statistical significance was defined as P < .05, and we calculated the effect sizes (d) and 95% confidence intervals (95% CI). Results: The average BMI and BFP were 22.6 ± 3.0% and 19.4 ± 2.2 kg/m2, respectively. Low BFP and low BMI were observed in 51 (38.6%) and 47 (35.6%) participants, respectively. Primary amenorrhea in 3 participants (2.3%) and 29 (22.1%) reported experiencing secondary amenorrhea; they had lower BFP than the dancers who did not experience amenorrhea (P = .041, 95% CI, -2.51 to -0.05). Conclusion: Female elite adolescent dancers in China may have lower BFP and menstrual problems. Given that lower BFP may contribute to the occurrence of menstruation disorders, it is essential to pay an attention to both BFP and the menstruation status in female elite adolescent dancers.

Bilateral Freiberg disease in a young female dancer: A case report.

Freiberg's infarction is the disorder of cartilage degeneration. The second metatarsal head is most vulnerable to Freiberg's infarction due to its longer length and relative immobility. It is exposed to repetitive stress even during normal activity. The multifactorial etiology of Freiberg's infarction is mentioned in the literature. It commonly affects the adolescent female with a female-to-male ratio of 5:1. High prevalence in adolescent females is explained in some literature due to wearing high heels, which leads to repetitive forced dorsiflexion injuries to the metatarsal head. Our case is an adolescent female of 20 years who was participating in dancing for 5 months. On examination, there is swelling and tenderness in the bilateral foot, more on the right side. Plain radiography showed the flattening of the head of the right second metatarsal with increased joint space. Mild sclerosis of the underlying bony cortex was seen. A mild deformity with flattening of the lateral surface of the head of the left second metatarsal was also seen.

Biomechanical Analysis of Latin Dancers' Lower Limb during Normal Walking.

Latin dance involves fundamental walking steps, integral to the dance process. While resembling daily walking, Latin dance demands higher balance levels, necessitating body adjustments by dancers. These adaptations affect dancers' gait biomechanics, prompting our study on gait differences between Latin dancers (LDs) and non-dancers (NDs). We enlisted 21 female Latin dancers and 21 subjects based on specific criteria. Participants executed walking tasks, with an independent sample t-test for 1-dimensional statistical parameter mapping (SPM 1d) analyzing stance phase variations between LDs and NDs. Notably, significant differences in ankle and hip external rotation were evident during the 16.43-29.47% (p = 0.015) and 86.35-100% (p = 0.014) stance phase. Moreover, pronounced distinctions in rectus Achilles tendon force (ATF) (12.83-13.10%, p = 0.049; 15.89-80.19%, p < 0.001) and Patellofemoral joint contact force (PTF) (15.85-18.31%, p = 0.039; 21.14-24.71%, p = 0.030) during stance were noted between LDs (Latin dancers) and NDs (Non-dancers). The study revealed dancers' enhanced balance attributed to external ankle rotation for dance stability, coupled with augmented Achilles tendon and patellofemoral joint strength from prolonged practice. Moreover, integrating suitable Latin dance into rehabilitation may benefit those with internal rotation gait issues.

The Effects of Emotional Labor on Work Strain and Nonwork Strain Among Dancers: A Person-Centered Approach.

Introduction: Emotional labor is an important research area, but four key gaps remain regarding outcomes of nonwork strains, explanatory frameworks beyond the conservation of resources theory, adoption of person-centered approaches, and subjects of performers. Methods: By surveying 183 Chinese dance students, we employed cluster analysis to examine the adoption of emotional labor strategies (ie, surface acting, deep acting, and expression of naturally felt emotions) and to explore the outcomes on work strain (ie, emotional exhaustion and reduced flow experience) and nonwork strain (ie, depression and anxiety) with introducing the allostatic load theory as an analytical basis. Results: Four types of emotional workers were identified, namely, flexible regulators (33.33%), authentic regulators (15.85%), display rules compliers (39.34%), and non-regulators (11.48%). Authentic regulators had the lowest emotional exhaustion. Non-regulators had the lowest flow. No differences emerged in depression or anxiety across clusters. Discussion: Findings partially align with past research showing risks of surface acting in terms of emotional exhaustion. However, all three strategies enhanced flow states. Moreover, dancers' work strains did not extend to psychological problems, unlike other professions. Possible explanations include training in emotional regulation and flow states in performing. Practical implications exist for training emotional regulation and fostering flow at work.

Acute respiratory failure induced by belly dancer's syndrome: A glance to a rare case report.

Respiratory myoclonus, also known as belly dancer's dyskinesia (BDD), is a rare manifestation of movement disorder characterized by repetitive choreiform involuntary movements involving the anterior abdominal muscles, the diaphragm, and other respiratory muscles. Currently, there is no definite pathophysiology that clearly explains this condition. A 25-year-old male with a known case of BDD presented with an exacerbation of involuntary and continuous writhing movements of the abdominal wall muscles associated with abdominal pain and shortness of breath over the past 2 days. Subsequently, he was intubated due to worsening respiratory distress a few days after his admission. He was then put on ultrasound-guided botulinum toxin A injections of 25 units over the left hemidiaphragm regularly. His symptoms markedly improved since then as the attacks had reduced to 5-6 monthly intervals. Administration of ultrasound-guided botulinum toxin A injections may help to control the exacerbation of BDD and might be an option for cases refractory to medical treatment and phrenic nerve ablation.

Trait representation of embodied cognition in dancers pivoting on the extended mirror neuron system: a resting-state fMRI study.

Introduction: Dance is an art form that integrates the body and mind through movement. Dancers develop exceptional physical and mental abilities that involve various neurocognitive processes linked to embodied cognition. We propose that dancers' primary trait representation is movement-actuated and relies on the extended mirror neuron system (eMNS). Methods: A total of 29 dancers and 28 non-dancer controls were recruited. A hierarchical approach of intra-regional and inter-regional functional connectivity (FC) analysis was adopted to probe trait-like neurodynamics within and between regions in the eMNS during rest. Correlation analyses were employed to examine the associations between dance training, creativity, and the FC within and between different brain regions. Results: Within the eMNS, dancers exhibited increased intra-regional FC in various brain regions compared to non-dancers. These regions include the left inferior frontal gyrus, left ventral premotor cortex, left anterior insula, left posterior cerebellum (crus II), and bilateral basal ganglia (putamen and globus pallidus). Dancers also exhibited greater intrinsic inter-regional FC between the cerebellum and the core/limbic mirror areas within the eMNS. In dancers, there was a negative correlation observed between practice intensity and the intrinsic FC within the eMNS involving the cerebellum and basal ganglia. Additionally, FCs from the basal ganglia to the dorsolateral prefrontal cortex were found to be negatively correlated with originality in dancers. Discussion: Our results highlight the proficient communication within the cortical-subcortical hierarchy of the eMNS in dancers, linked to the automaticity and cognitive-motor interactions acquired through training. Altered functional couplings in the eMNS can be regarded as a unique neural signature specific to virtuoso dancers, which might predispose them for skilled dancing performance, perception, and creation.