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Clivus length distinguishes between asymptomatic healthy controls and symptomatic adult women with Chiari malformation type I.
Neuroradiology. 2020 Nov; 62(11):1389-1400.N

Abstract

PURPOSE

While the presence of cerebellar tonsillar descent in radiological images has been used as evidence of Chiari malformation type I (CMI), tonsillar ectopia alone is insufficient to identify individuals with symptomatic CMI. This study sought to identify differences in brain morphology between symptomatic CMI and healthy controls in adult females.

METHODS

Two hundred and ten adult females with symptomatic CMI and 90 age- and body mass index-matched asymptomatic female controls were compared using seven brain morphometric measures visible on magnetic resonance images. The CMI and control groups were divided into four subgroups based on the tonsillar position (TP) relative to the foramen magnum: group 1 was made up of healthy controls with normal TP (TP < 0 mm); group 2 was comprised of control individuals with low-lying TP (1-5 mm); group 3 was comprised of symptomatic CMI patients with low-lying TP (1-5 mm); group 4 contained symptomatic CMI patients with severe tonsillar descent (6-13 mm).

RESULTS

All morphometrics for symptomatic CMI with severe tonsillar descent were significantly different than those for both control groups. The CMI group with low-lying TP was significantly different for four measures when compared to controls with normal TP. However, only clivus length was statistically different between the CMI and healthy control groups with low-lying TP.

CONCLUSION

This study demonstrates that clivus length distinguishes adult female healthy individuals with low-lying tonsils from those with symptomatic CMI. Further investigation is required to understand the importance of a shorter clivus length on CMI symptomatology and pathophysiology.

Authors+Show Affiliations

Conquer Chiari Research Center, Department of Biomedical Engineering, The University of Akron, Akron, OH, USA. bn23@zips.uakron.edu.Conquer Chiari Research Center, Department of Biomedical Engineering, The University of Akron, Akron, OH, USA.Conquer Chiari Research Center, Department of Mechanical Engineering, The University of Akron, Akron, OH, USA.Department of Psychology, Middle Tennessee State University, Murfreesboro, TN, USA.Fluids and structure (FaST) Laboratory, Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL, USA.Conquer Chiari, Wexford, PA, USA.Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA.Conquer Chiari Research Center, Department of Psychology, The University of Akron, Akron, OH, USA.Department of Neurosurgery, University of Chicago, Chicago, IL, USA.Conquer Chiari Research Center, Department of Biomedical Engineering, The University of Akron, Akron, OH, USA. Conquer Chiari Research Center, Department of Mechanical Engineering, The University of Akron, Akron, OH, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32418026

Citation

Nwotchouang, Blaise Simplice Talla, et al. "Clivus Length Distinguishes Between Asymptomatic Healthy Controls and Symptomatic Adult Women With Chiari Malformation Type I." Neuroradiology, vol. 62, no. 11, 2020, pp. 1389-1400.
Nwotchouang BST, Eppelheimer MS, Ibrahimy A, et al. Clivus length distinguishes between asymptomatic healthy controls and symptomatic adult women with Chiari malformation type I. Neuroradiology. 2020;62(11):1389-1400.
Nwotchouang, B. S. T., Eppelheimer, M. S., Ibrahimy, A., Houston, J. R., Biswas, D., Labuda, R., Bapuraj, J. R., Allen, P. A., Frim, D., & Loth, F. (2020). Clivus length distinguishes between asymptomatic healthy controls and symptomatic adult women with Chiari malformation type I. Neuroradiology, 62(11), 1389-1400. https://doi.org/10.1007/s00234-020-02453-5
Nwotchouang BST, et al. Clivus Length Distinguishes Between Asymptomatic Healthy Controls and Symptomatic Adult Women With Chiari Malformation Type I. Neuroradiology. 2020;62(11):1389-1400. PubMed PMID: 32418026.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clivus length distinguishes between asymptomatic healthy controls and symptomatic adult women with Chiari malformation type I. AU - Nwotchouang,Blaise Simplice Talla, AU - Eppelheimer,Maggie S, AU - Ibrahimy,Alaaddin, AU - Houston,James R, AU - Biswas,Dipankar, AU - Labuda,Richard, AU - Bapuraj,Jayapalli Rajiv, AU - Allen,Philip A, AU - Frim,David, AU - Loth,Francis, Y1 - 2020/05/16/ PY - 2020/03/05/received PY - 2020/04/29/accepted PY - 2020/5/18/pubmed PY - 2021/7/8/medline PY - 2020/5/18/entrez KW - Cerebellar tonsils KW - Chiari malformation type I KW - Clivus length KW - Magnetic resonance imaging KW - Morphometrics SP - 1389 EP - 1400 JF - Neuroradiology JO - Neuroradiology VL - 62 IS - 11 N2 - PURPOSE: While the presence of cerebellar tonsillar descent in radiological images has been used as evidence of Chiari malformation type I (CMI), tonsillar ectopia alone is insufficient to identify individuals with symptomatic CMI. This study sought to identify differences in brain morphology between symptomatic CMI and healthy controls in adult females. METHODS: Two hundred and ten adult females with symptomatic CMI and 90 age- and body mass index-matched asymptomatic female controls were compared using seven brain morphometric measures visible on magnetic resonance images. The CMI and control groups were divided into four subgroups based on the tonsillar position (TP) relative to the foramen magnum: group 1 was made up of healthy controls with normal TP (TP < 0 mm); group 2 was comprised of control individuals with low-lying TP (1-5 mm); group 3 was comprised of symptomatic CMI patients with low-lying TP (1-5 mm); group 4 contained symptomatic CMI patients with severe tonsillar descent (6-13 mm). RESULTS: All morphometrics for symptomatic CMI with severe tonsillar descent were significantly different than those for both control groups. The CMI group with low-lying TP was significantly different for four measures when compared to controls with normal TP. However, only clivus length was statistically different between the CMI and healthy control groups with low-lying TP. CONCLUSION: This study demonstrates that clivus length distinguishes adult female healthy individuals with low-lying tonsils from those with symptomatic CMI. Further investigation is required to understand the importance of a shorter clivus length on CMI symptomatology and pathophysiology. SN - 1432-1920 UR - https://www.unboundmedicine.com/medline/citation/32418026/Clivus_length_distinguishes_between_asymptomatic_healthy_controls_and_symptomatic_adult_women_with_Chiari_malformation_type_I_ L2 - https://dx.doi.org/10.1007/s00234-020-02453-5 DB - PRIME DP - Unbound Medicine ER -