Evidence map›Paper›PMID 40315599›Full record

ArticleJournal of neurosurgery. Pediatrics2025

Clinical phenotypes among patients with familial forms of Chiari malformation type 1.

Kedous Y Mekbib, William Muñoz, Garrett Allington, Shujuan Zhao, Neel H Mehta, Carla Fortes, John P Shohfi, Baojian Fan, Carol Nelson-Williams, Tyrone DeSpenza and 4 more

Abstract read
In one paragraph

Article in Journal of neurosurgery. Pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Chiari I malformation.Nature reviews. Disease primers · 2026
    Review
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

14 authors.

Kedous Y Mekbib1Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota.
William Muñoz *2Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts.
Garrett Allington4Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York.
Shujuan Zhao5Department of Genetics, Washington University School of Medicine, St. Louis, Missouri.
Neel H Mehta2Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts.
Carla Fortes2Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts.
John P Shohfi2Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts.
Baojian Fan2Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts.
Carol Nelson-Williams6Department of Genetics, Yale University School of Medicine, New Haven, Connecticut.
Tyrone DeSpenza7Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina.
William E Butler2Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts.
Seth L Alper8Division of Nephrology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Eric M Jackson *11Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and.
Kristopher T Kahle *2Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts.

Funding

Human Genetics and Molecular Mechanisms of Vein of Galen Aneurysmal MalformationR01NS117609 · NINDS · YALE UNIVERSITY · PI Titus Jonathon Boggon, Kristopher T. Kahle · 2020 to 2026
$3.3M
Modulation of Choroid Plexus Immuno-secretory Function to Restore Cerebrospinal Fluid Homeostasis in HydrocephalusR01NS109358 · NINDS · YALE UNIVERSITY · PI Kristopher T. Kahle · 2018 to 2026
$2.4M
NINDS NIH HHS R01 NS109358NINDS NIH HHS R01 NS117609
6 · The paper itself

Abstract

objectiveChiari malformation type 1 (CM1) is the most common neurological disorder of the craniocervical junction. CM1 is characterized by cerebellar tonsillar herniation below the foramen magnum, causing CSF obstruction and neural compression. Patients with CM1 suffer from highly variable symptoms, progression, comorbidities, and outcomes, partly due to poor understanding of CM1 pathogenesis. In this paper, the authors present the only familial CM1 cohort study to statistically assess intrafamilial clinical phenotypes to date.

methodsComprehensive medical, surgical, and family histories and neuroimaging were collected from families with multiple CM1-affected family members. Univariate analysis was performed for each symptom, comorbidity, or surgery to compare observed versus expected frequencies of affected patients with another CM1-affected family member with the same clinical characteristic.

resultsTwenty-four new familial CM1 cases (totaling 57 patients with CM1) are presented. Intrafamilial similarities were identified for age of onset, symptoms such as headaches (p = 0.007) and neck pain (p = 0.018), neurological comorbidities such as syringomyelia (p = 0.003) and hydrocephalus (p = 0.0001), neurodevelopmental conditions such as dyslexia (p < 0.0001), and connective tissue disorders (CTDs) such as Ehlers-Danlos syndrome (p < 0.0001).

conclusionsThese results suggest that CM1 and its associated clinical phenotypes, including age of onset, clinical symptoms, neurological comorbidities, neurodevelopmental conditions, and CTDs, are genetically influenced. Whole-exome sequencing of CM1 patient-parent trios has the potential to identify the genetic determinants of CM1, with implications for neurosurgical management.

Indexed as

Arnold-Chiari MalformationAdolescentAdultChildChild, PreschoolCohort StudiesFemaleHumansMaleMiddle AgedPhenotypeSyringomyeliaYoung AdultChiari malformation type 1craniocervical junctionhuman geneticsneurodevelopmental disordersposterior fossa decompressionwhole-exome sequencing

Identifiers

PMID40315599
PMCPMC12558010

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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.