title: Task-specific and general cognitive effects in Chiari malformation type I.
abstract: OBJECTIVE
  Our objective was to use episodic memory and executive function tests to determine whether or not Chiari Malformation Type I (CM) patients experience cognitive dysfunction.
  
  
  BACKGROUND
  CM is a neurological syndrome in which the cerebellum descends into the cervical spine causing neural compression, severe headaches, neck pain, and number of other physical symptoms. While primarily a disorder of the cervico-medullary junction, both clinicians and researchers have suspected deficits in higher-level cognitive function.
  
  
  METHODS
  We tested 24 CM patients who had undergone decompression neurosurgery and 24 age- and education-matched controls on measures of immediate and delayed episodic memory, as well as three measures of executive function.
  
  
  RESULTS
  The CM group showed performance decrements relative to the controls in response inhibition (Stroop interference), working memory computational speed (Ospan), and processing speed (automated digit symbol substitution task), but group differences in recall did not reach statistical significance. After statistical control for depression and anxiety scores, the group effects for working memory and processing speed were eliminated, but not for response inhibition. This response inhibition difference was not due to overall general slowing for the CM group, either, because when controls' data were transformed using the linear function fit to all of the reaction time tasks, the interaction with group remained statistically significant. Furthermore, there was a multivariate group effect for all of the response time measures and immediate and delayed recall after statistical control of depression and anxiety scores.
  
  
  CONCLUSIONS
  These results suggest that CM patients with decompression surgery exhibit cognitive dysfunction compared to age- and education-matched controls. While some of these results may be related to anxiety and depression (likely proxies for chronic pain), response inhibition effects, in particular, as well as a general cognitive deficit persisted even after control for anxiety and decompression.
authors.affiliation: Department of Psychology, University of Akron, Akron, Ohio, United States of America; Conquer Chiari Research Center, University of Akron, Akron, Ohio, United States of America.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Allen
authors.affiliation: Department of Psychology, University of Akron, Akron, Ohio, United States of America.
authors.forename: James R
authors.initials: JR
authors.lastname: Houston
authors.affiliation: Department of Psychology, University of Akron, Akron, Ohio, United States of America; Conquer Chiari Research Center, University of Akron, Akron, Ohio, United States of America.
authors.forename: Joshua W
authors.initials: JW
authors.lastname: Pollock
authors.affiliation: Department of Psychology, University of Akron, Akron, Ohio, United States of America.
authors.forename: Christopher
authors.initials: C
authors.lastname: Buzzelli
authors.affiliation: Department of Psychology, University of Akron, Akron, Ohio, United States of America.
authors.forename: Xuan
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Psychology, University of Akron, Akron, Ohio, United States of America.
authors.forename: A Katherine
authors.initials: AK
authors.lastname: Harrington
authors.affiliation: Conquer Chiari Research Center, University of Akron, Akron, Ohio, United States of America; Department of Mechanical Engineering, University of Akron, Akron, Ohio, United States of America.
authors.forename: Bryn A
authors.initials: BA
authors.lastname: Martin
authors.affiliation: Conquer Chiari Research Center, University of Akron, Akron, Ohio, United States of America; Department of Mechanical Engineering, University of Akron, Akron, Ohio, United States of America.
authors.forename: Francis
authors.initials: F
authors.lastname: Loth
authors.affiliation: School of Psychological Science, Oregon State University, Corvallis, Oregon, United States of America.
authors.forename: Mei-Ching
authors.initials: MC
authors.lastname: Lien
authors.affiliation: Neurological Center for Pain, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America.
authors.forename: Jahangir
authors.initials: J
authors.lastname: Maleki
authors.affiliation: Department of Neurological Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Luciano
mesh_terms: D000293:Adolescent; D000328:Adult; D001139:Arnold-Chiari Malformation / Q000503:physiopathology*; D003071:Cognition; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D061212:Memory, Episodic; D008875:Middle Aged; D011930:Reaction Time / Q000502:physiology; D057190:Stroop Test; D055815:Young Adult
references.citation: Synapse. 2011 Nov;65(11):1204-12
references.pmid: 21638338
references.citation: Radiology. 2004 Jan;230(1):77-87
references.pmid: 14645885
references.citation: Brain. 1998 Apr;121 ( Pt 4):561-79
references.pmid: 9577385
references.citation: Neurol Sci. 2011 Dec;32 Suppl 3:S307-9
references.pmid: 21983865
references.citation: J Neurosci. 2004 Nov 17;24(46):10410-5
references.pmid: 15548656
references.citation: Neuropsychologia. 2010 Jan;48(1):319-33
references.pmid: 19786039
references.citation: Neurol Res. 2011 Apr;33(3):247-60
references.pmid: 21513645
references.citation: Psychol Rev. 1996 Jul;103(3):403-28
references.pmid: 8759042
references.citation: Behav Res Methods. 2005 Aug;37(3):498-505
references.pmid: 16405146
references.citation: J Exp Psychol Gen. 1991 Jun;120(2):215-23
references.pmid: 1830612
references.citation: J Genet Couns. 2003 Aug;12(4):297-311
references.pmid: 26141174
references.citation: Brain. 2000 May;123 ( Pt 5):1051-61
references.pmid: 10775549
references.citation: Cereb Cortex. 2009 Oct;19(10):2485-97
references.pmid: 19592571
references.citation: Pediatr Clin North Am. 2004 Apr;51(2):477-90
references.pmid: 15062680
references.citation: Br J Clin Psychol. 2005 Jun;44(Pt 2):227-39
references.pmid: 16004657
references.citation: PLoS One. 2013 May 15;8(5):e64630
references.pmid: 23691256
references.citation: Scand J Pain. 2017 Dec 29;2(2):47-54
references.pmid: 29913734
references.citation: Neurosurgery. 1999 May;44(5):1005-17
references.pmid: 10232534
references.citation: Neuroimage. 2004 Dec;23(4):1317-25
references.pmid: 15589096
references.citation: Surg Neurol Int. 2012;3:165
references.pmid: 23372981
references.citation: J Clin Exp Neuropsychol. 2012;34(1):35-56
references.pmid: 22047489
references.citation: World Neurosurg. 2011 Jul-Aug;76(1-2):189-94
references.pmid: 21839973
references.citation: Neuroimage. 2011 Jun 1;56(3):1608-21
references.pmid: 21397701
references.citation: Neurol Res. 2011 Apr;33(3):272-7
references.pmid: 21513647
references.citation: Pain Med. 2006 Sep-Oct;7(5):444-52
references.pmid: 17014605
references.citation: Physiotherapy. 1980 Aug;66(8):271-3
references.pmid: 6450426
references.citation: Proc Natl Acad Sci U S A. 1999 May 25;96(11):6558-63
references.pmid: 10339627
references.citation: Ann Neurol. 1992 Mar;31(3):333-6
references.pmid: 1637140
references.citation: J Neurosci. 1988 Nov;8(11):4049-68
references.pmid: 2846794
references.citation: J Exp Psychol Gen. 2004 Mar;133(1):101-135
references.pmid: 14979754
references.citation: Exp Aging Res. 2005 Oct-Dec;31(4):355-91
references.pmid: 16147458
references.citation: Neuropsychiatry Neuropsychol Behav Neurol. 2002 Mar;15(1):56-65
references.pmid: 11877552
references.citation: J Am Acad Nurse Pract. 2004 Mar;16(3):134-8
references.pmid: 15130068
references.citation: Curr Dir Psychol Sci. 2007 Apr;16(2):70-74
references.pmid: 18080001
references.citation: Prog Neurobiol. 2011 Mar;93(3):385-404
references.pmid: 21216272
references.citation: Psychol Aging. 1992 Dec;7(4):594-601
references.pmid: 1466828