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Correlation of force control with regional spinal DTI in patients with cervical spondylosis without signs of spinal cord injury on conventional MRI

  • Musculoskeletal
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Abstract

Objectives

The aim of this study was to investigate spinal cord structure in patients with cervical spondylosis where conventional MRI fails to reveal spinal cord damage.

Methods

We performed a cross-sectional study of patients with cervical spondylosis without conventional MRI findings of spinal cord damage and healthy controls. Subjects were studied using spinal diffusion tensor imaging (DTI), precision grip and foot force-tracking tasks, and a clinical examination including assessment of neurological signs. A regional analysis of lateral and medial spinal white matter across multiple cervical levels (C1–C5) was performed.

Results

DTI revealed reduced fractional anisotropy (FA) and increased radial diffusivity (RD) in the lateral spinal cord at the level of greatest compression (lowest Pavlov ratio) in patients (p < 0.05). Patients with spondylosis had greater error and longer release duration in both grip and foot force-tracking. Similar spinal cord deficits were present in patients without neurological signs. Increased error in grip and foot tracking (low accuracy) correlated with increased RD in the lateral spinal cord at the level of greatest compression (p ≤ 0.01).

Conclusions

Spinal DTI can detect subtle spinal cord damage of functional relevance in cervical spondylosis, even in patients without signs on conventional T2-imaging and without neurological signs.

Key Points

• DTI reveals spinal cord changes in cervical spondylosis with few symptoms

• DTI changes were present despite normal spinal cord on conventional MRI

• DTI parameters correlated with force control accuracy in hand and foot

• Spinal DTI is a promising technique for patients with cervical spondylosis

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Abbreviations

AD:

Axial diffusivity

ADC:

Apparent diffusion coefficient

DTI:

Diffusion tensor imaging

FA:

Fractional anisotropy

N:

Newton

RD:

Radial diffusivity

ROI:

Region of interest

SD:

Standard deviation

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Acknowledgments

This study was in part supported by grants to Påvel Lindberg of Hjärnfonden (the Swedish Brain Foundation) and of the Institut pour la Recherche sur la Moelle Epinière et l'Encéphale (IRME, Paris). The authors thank URC-CIC Paris Centre for implementation and monitoring of the study. The scientific guarantor of this publication is Marc A. Maier. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: cross-sectional study, performed at one institution.

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Authors and Affiliations

  1. FR 3636 Neurosciences, Université Paris Descartes, Sorbonne Paris Cité, 45 rue des Saints Pères, F-75006, Paris, France

    Påvel G. Lindberg, Fidan Ozcan, Antoine Feydy & Marc A. Maier

  2. Centre de Psychiatrie et Neurosciences, Inserm U894, 75014, Paris, France

    Påvel G. Lindberg

  3. Université Paris Descartes, Sorbonne Paris Cité, F-75006, Paris, France

    Påvel G. Lindberg, Katherine Sanchez, François Rannou, Serge Poiraudeau, Antoine Feydy & Marc A. Maier

  4. Service de Radiologie B, APHP, CHU Cochin, Faculté de Médecine, Université Paris Descartes, F-75014, Paris, France

    Påvel G. Lindberg & Antoine Feydy

  5. Université Paris Diderot, Sorbonne Paris Cité, F-75205, Paris, France

    Marc A. Maier

  6. Service de Médecine Physique et de Réadaptation, APHP, CHU Cochin, Paris, France

    Katherine Sanchez, François Rannou & Serge Poiraudeau

  7. INSERM U1153 Epidémiologie Clinique des Maladies Ostéo-Articulaires, Paris, France

    Katherine Sanchez, François Rannou & Serge Poiraudeau

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  1. Påvel G. Lindberg
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  2. Katherine Sanchez
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  3. Fidan Ozcan
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  7. Marc A. Maier
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Correspondence to Påvel G. Lindberg.

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Lindberg, P.G., Sanchez, K., Ozcan, F. et al. Correlation of force control with regional spinal DTI in patients with cervical spondylosis without signs of spinal cord injury on conventional MRI. Eur Radiol 26, 733–742 (2016). https://doi.org/10.1007/s00330-015-3876-z

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  • DOI: https://doi.org/10.1007/s00330-015-3876-z

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