Evidence map›Paper›PMID 34662899›Full record

ArticleNeurosurgery2021

Cognitive and Psychological Functioning in Chiari Malformation Type I Before and After Surgical Decompression - A Prospective Cohort Study.

Scott C Seaman, Carolina Deifelt Streese, Kenneth Manzel, Janina Kamm, Arnold H Menezes, Daniel Tranel, Brian J Dlouhy

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurosurgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Scott C SeamanDepartment of Neurosurgery, University of Iowa Hospitals and Clinics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA.
Carolina Deifelt StreeseDepartment of Neurology, University of Iowa Hospitals and Clinics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA.
Kenneth ManzelDepartment of Neurology, University of Iowa Hospitals and Clinics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA.
Janina KammDepartment of Clinical Psychology, The Chicago School of Professional Psychology, Chicago, Illinois, USA.
Arnold H MenezesDepartment of Neurosurgery, University of Iowa Hospitals and Clinics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA.
Daniel TranelDepartment of Neurology, University of Iowa Hospitals and Clinics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA.
Brian J DlouhyDepartment of Neurosurgery, University of Iowa Hospitals and Clinics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA.
University of Iowa Hospitals and Clinics · USThe Chicago School of Professional Psychology · US

Funding

Causal mapping of emotion networks with concurrent electrical stimulation and fMRIU01NS103780 · NINDS · CALIFORNIA INSTITUTE OF TECHNOLOGY · PI ADOLPHS, RALPH, HOWARD, MATTHEW A. · 2018 to 2020
$2.9M
NINDS NIH HHS U01 NS103780
6 · The paper itself

Abstract

backgroundChiari Malformation Type I (CM-I) is defined as cerebellar tonsil displacement more than 5 mm below the foramen magnum. This displacement can alter cerebrospinal fluid flow at the cervicomedullary junction resulting in Valsalva-induced headaches and syringomyelia and compress the brainstem resulting in bulbar symptoms. However, little is known about cognitive and psychological changes in CM-I.

objectiveTo prospectively assess cognitive and psychological performance in CM-I and determine whether changes occur after surgical decompression.

methodsBlinded evaluators assessed symptomatic CM-I patients ages ≥18 with a battery of neuropsychological and psychological tests. Testing was conducted preoperatively and 6 to 18 mo postoperatively. Data were converted to Z-scores based on normative data, and t-tests were used to analyze pre-post changes.

resultsA total of 26 patients were included, with 19 completing both pre- and post-op cognitive assessments. All patients had resolution of Valsalva-induced headaches and there was improvement in swallowing dysfunction (P < .0001), ataxia (P = .008), and sleep apnea (P = .021). Baseline performances in visual perception and construction (z = -1.11, P = .001) and visuospatial memory (z = -0.93, P = .002) were below average. Pre-post comparisons showed that CM-I patients had stable cognitive and psychological functioning after surgery, without significant changes from preoperative levels.

conclusionCM-I patients had below average performance in visuospatial and visuoconstructional abilities preoperatively. Prospective longitudinal data following surgery demonstrated improved neurologic status without any decline in cognition or psychological functioning. Routine pre- and postoperative formal neuropsychological assessment in CM-I patients help quantify cognitive and behavioral changes associated with surgical decompression.

Indexed as

Arnold-Chiari MalformationSyringomyeliaCognitionDecompression, SurgicalForamen MagnumHumansMagnetic Resonance ImagingProspective StudiesTreatment OutcomeBrain fogBrainstemCerebellumChiari malformationICognitive outcomesProspective study

Identifiers

PMID34662899
PMCPMC8600175
OpenAlexW3205642171

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.