Upon maturation, these individuals were observed to have smaller prostates which were underdeveloped, and were also observed to lack incidence of male pattern baldness.In 1975, copies of Imperato-McGinleys presentation were seen by P. Roy Vagelos, who was then serving as Mercks basic-research chief. He was intrigued by the notion that decreased levels of DHT led to the development of smaller prostates. Dr. Vagelos then sought to create a drug which could mimic the condition found in these children to treat older men who had  benign prostatic hyperplasia.Finasteride was developed by Merck under the code name MK-906. A team led by chemist Gary Rasmusson and biologist Jerry Brooks developed potential 5α-reductase inhibitors based on transition state inhibitors, using an iterative process of molecular design, testing, and redesign. In 1992, finasteride (5 mg) was approved by the U.S. Food and Drug Administration (FDA) for treatment of BPH, which Merck marketed under the brand name Proscar. Rasmusson and Brooks were awarded IPOs "Inventor of the Year" award in 1993 for their work on finasteride. In 1997, Merck was successful in obtaining FDA approval for a second indication of finasteride (1 mg) for treatment of male pattern hair loss, which was marketed under the brand name Propecia. It was the first 5α-reductase inhibitor to be introduced and was followed by dutasteride in 2001. The first study of finasteride in the treatment of hirsutism in women was published in 1994.
The work of several doctors such as Nancy Byl and Joaquin Farias has shown that sensorimotor retraining activities and proprioceptive stimulation can induce neuroplasticity, making it possible for patients to recover substantial function that was lost to focal dystonia. For some dystonias, Deep brain stimulation may be considered where BoNT treatment fails. If the dystonia is cause by an underlying nerve entrapment, surgical decompression has shown to have improvement in some cases. Prognosis
Recovery from focal dystonia has varying results, ranging from minimal improvement in function to complete recovery and ranging from weeks to years. Prevention
Though studies on prevention of focal dystonia is limited, it is believed for musicians dystonia that mindfulness of muscle use and proper rest can help prevent focal dystonia and injury. Performing Arts Medicine
Musicians Dystonia
Musicians dystonia treatment studies have yielded varying results. This condition can often be misdiagnosed as psychogenic, as this was previously thought to be its cause. In this population, men are affected more than women from 20 to 60 years of age. Evaluation of musicians dystonia should include history before and after symptom onset and observation of playing the instrument, as deficits can be subtle and considered minor to the general population. Treatment modalities available, such as BoNT/A, leave many musicians unsatisfied due to muscle weakness and lack of improvement in muscle control. In musicians, this is commonly associated with overuse or high volume of practicing.