title: Correlation of force control with regional spinal DTI in patients with cervical spondylosis without signs of spinal cord injury on conventional MRI.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: FR 3636 Neurosciences, Université Paris Descartes, Sorbonne Paris Cité, 45 rue des Saints Pères, F-75006, Paris, France. pavel.lindberg@inserm.fr.|Centre de Psychiatrie et Neurosciences, Inserm U894, 75014, Paris, France. pavel.lindberg@inserm.fr.|Université Paris Descartes, Sorbonne Paris Cité, F-75006, Paris, France. pavel.lindberg@inserm.fr.|Service de Radiologie B, APHP, CHU Cochin, Faculté de Médecine, Université Paris Descartes, F-75014, Paris, France. pavel.lindberg@inserm.fr.
authors.forename: Påvel G
authors.identifier: http://orcid.org/0000-0001-6976-6387
authors.initials: PG
authors.lastname: Lindberg
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, F-75006, Paris, France.|Service de Médecine Physique et de Réadaptation, APHP, CHU Cochin, Paris, France.|INSERM U1153 Epidémiologie Clinique des Maladies Ostéo-Articulaires, Paris, France.
authors.forename: Katherine
authors.initials: K
authors.lastname: Sanchez
authors.affiliation: FR 3636 Neurosciences, Université Paris Descartes, Sorbonne Paris Cité, 45 rue des Saints Pères, F-75006, Paris, France.
authors.forename: Fidan
authors.initials: F
authors.lastname: Ozcan
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, F-75006, Paris, France.|Service de Médecine Physique et de Réadaptation, APHP, CHU Cochin, Paris, France.|INSERM U1153 Epidémiologie Clinique des Maladies Ostéo-Articulaires, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Rannou
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, F-75006, Paris, France.|Service de Médecine Physique et de Réadaptation, APHP, CHU Cochin, Paris, France.|INSERM U1153 Epidémiologie Clinique des Maladies Ostéo-Articulaires, Paris, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Poiraudeau
authors.affiliation: FR 3636 Neurosciences, Université Paris Descartes, Sorbonne Paris Cité, 45 rue des Saints Pères, F-75006, Paris, France.|Université Paris Descartes, Sorbonne Paris Cité, F-75006, Paris, France.|Service de Radiologie B, APHP, CHU Cochin, Faculté de Médecine, Université Paris Descartes, F-75014, Paris, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Feydy
authors.affiliation: FR 3636 Neurosciences, Université Paris Descartes, Sorbonne Paris Cité, 45 rue des Saints Pères, F-75006, Paris, France.|Université Paris Descartes, Sorbonne Paris Cité, F-75006, Paris, France.|Université Paris Diderot, Sorbonne Paris Cité, F-75205, Paris, France.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Maier
mesh_terms: D003430:Cross-Sectional Studies; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013116:Spinal Cord / Q000473:pathology*; D055009:Spondylosis / Q000473:pathology*
keywords: Cervical spondylosis; Diffusion tensor imaging; Force control; Pavlov ratio; Spinal cord