{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T06:48:22Z","timestamp":1792219702749,"version":"4.4.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T00:00:00Z","timestamp":1634515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"abstract":"Abstract<\/jats:title>\n \n BACKGROUND<\/jats:title>\n Chiari Malformation Type I (CM-I) is defined as cerebellar tonsil displacement more than 5\u00a0mm 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.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE<\/jats:title>\n To prospectively assess cognitive and psychological performance in CM-I and determine whether changes occur after surgical decompression.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n Blinded evaluators assessed symptomatic CM-I patients ages \u226518 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\n t<\/jats:italic>\n -tests were used to analyze pre-post changes.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n A 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 (\n P<\/jats:italic>\n \u00a0<\u00a0.0001), ataxia (\n P<\/jats:italic>\n \u00a0=\u00a0.008), and sleep apnea (\n P<\/jats:italic>\n \u00a0=\u00a0.021). Baseline performances in visual perception and construction (z = \u22121.11,\n P<\/jats:italic>\n \u00a0=\u00a0.001) and visuospatial memory (z = \u22120.93,\n P<\/jats:italic>\n \u00a0=\u00a0.002) 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.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n CM-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.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/neuros\/nyab353","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T07:41:57Z","timestamp":1631086917000},"page":"1087-1096","source":"Crossref","is-referenced-by-count":19,"title":["Cognitive and Psychological Functioning in Chiari Malformation Type I Before and After Surgical Decompression - A Prospective Cohort Study"],"prefix":"10.1227","volume":"89","author":[{"given":"Scott C","family":"Seaman","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Iowa Hospitals and Clinics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina Deifelt","family":"Streese","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Manzel","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janina","family":"Kamm","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology, The Chicago School of Professional Psychology, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnold H","family":"Menezes","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Iowa Hospitals and Clinics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Tranel","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA"},{"name":"Iowa Neuroscience Institute, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA"},{"name":"Department of Psychological and Brain Sciences, University of Iowa College of Liberal Arts and Sciences, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J","family":"Dlouhy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Iowa Hospitals and Clinics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA"},{"name":"Pappajohn Biomedical Institute, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA"},{"name":"Iowa Neuroscience Institute, University of Iowa Carver College of 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