Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Höllein, C.
Structural MRI of the cervical spine in patients with cervical dystonia.
Humanmedizin; [ Diplomarbeit ] Medical University of Graz; 2014. pp. 151
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Katschnig-Winter Petra
- Schmidt Reinhold
- Schwingenschuh Petra
- Altmetrics:
- Abstract:
- Introduction: Cervical dystonia, which is the most common form of focal dystonia in the adulthood, is a rare disease. Only a few studies deal with this disease pattern especially with regard to the etiology and botulinum toxin therapy. In our study we investigated if structural changes of the cervical spine on MRI images are more frequent in patients with cervical dystonia than in the general population and which clinical parameters correlate with these abnormalities. Finally, we investigated whether there are any clinical parameters which strengthen the indication for an MRI of the cervical spine in patients with cervical dystonia. Methods: We recruited 30 patients (8 men, 22 women) with cervical dystonia. Three months apart, two identical examinations were performed including medical history, a neurological examination and the evaluation of the cervical dystonia by means of three different rating scales (TSUI Score, Toronto Western Spasmodic Torticollis Rating Scale, Burke-Fahn-Marsden Scale). In the same period, MRI of the cervical spine was performed, which was analyzed by three experienced neuroradiologists with the help of different MRI rating scales (Kang, Matsumoto, Modic). For comparison 21 healthy participants were recruited who also underwent the above mentioned examination and the MRI examination of the cervical spine. Results: The inter-rater reliability of each MRI rating scale which was evaluated with the intraclass correlation coefficient and Fleiss¿ kappa revealed good results in most of the cases. Concerning structural changes of the cervical spine, no major differences between patients and healthy participants were found. Cervical spine changes in patients were more prominent in segment C3/C4 and C4/C5 with regard to individual clinical parameters. Interestingly, the clinical symptom pain was not associated with imaging changes. Conclusion: Based on our results, we can make four statements. MRI rating scales we used were reliable. No major structural differences were found between patients and controls. Structural changes in patients with cervical dystonia seem to be associated with clinical parameters predominantly in segment C3/C4 and C4/C5. However, the clinical relevance of these associations is debatable. Based on our study results, magnetic resonance imaging of the cervical spine in patients with cervical dystonia should only be considered if on clinical basis a morphological correlate is suspected, since structural changes are very common in patients and in the general population, most likely due to degenerative changes. In order to make any further statements, studies with larger study population are needed.