Background: Cervical dystonia is the most common form of focal dystonia. The frequency and pattern of degenerative changes of the cervical spine in patients with cervical dystonia and their relation to clinical symptoms remain unclear as no direct comparison to healthy controls has been performed yet. Here, we used magnetic resonance imaging (MRI) to investigate (1) whether structural abnormalities of the cervical spine are more common in patients with cervical dystonia compared to age-matched healthy controls, (2) if there are clinical predictors for abnormalities on MRI, and (3) to calculate the inter-rater reliability of the respective radiological scales. Methods: Twenty-five consecutive patients with cervical dystonia and 20 age-matched healthy controls were included in the study. MRI scans of the cervical spine were analyzed separately by three experienced raters blinded to clinical information, applying different MRI rating scales. Structural abnormalities were compared between groups for upper, middle, and lower cervical spine segments. The associations between scores differentiating both groups and clinical parameters were assessed in dystonia patients. Additionally, inter-rater reliability of the MRI scales was calculated. Results: Comparing structural abnormalities, we found minor differences in the middle cervical spine, indicated by a higher MRI total score in patients but no significant correlation between clinical parameters and MRI changes. Inter-rater reliability was satisfying for most of the MRI rating scales. Conclusion: Our results do not provide evidence for a role of MRI of the cervical spine in the routine work-up of patients with cervical dystonia in the absence of specific clinical signs or symptoms.

中文翻译：

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颈肌张力障碍患者和年龄匹配的健康对照组之间的颈椎微小结构差异。

背景：颈肌张力障碍是局灶性肌张力障碍的最常见形式。颈肌张力障碍患者颈椎退行性改变的频率和方式及其与临床症状的关系尚不清楚，因为尚未进行与健康对照的直接比较。在这里，我们使用磁共振成像（MRI）研究（1）与年龄匹配的健康对照组相比，颈肌张力障碍患者颈椎结构异常是否更常见，（2）MRI是否存在临床预测指标（3）计算各个放射量表的评分者间可靠性。方法：本研究纳入了25例连续的宫颈肌张力障碍患者和20个年龄匹配的健康对照者。颈椎的MRI扫描由三位对临床信息不了解的经验丰富的评估人员分别进行分析，并应用不同的MRI评分量表。比较两组上，中，下颈椎节段的结构异常。在肌张力障碍患者中评估区分两组的得分与临床参数之间的关联。此外，还计算了MRI量表的评分者间可靠性。结果：比较结构异常，我们发现中颈椎有细微差别，这表明患者的MRI总得分较高，但临床参数与MRI变化之间无显着相关性。对于大多数MRI评分量表，评分者间的可靠性令人满意。结论：