Psychological implications in adults with Chiari Malformation Type I

Slides are available on request

Event.

Bobby Jones CSF 2023 Fall Research Meeting

Topic.

In this talk, we present a data update on the associations among cognitive/affective data, brain-based structural and functional measures, and biomarker results from our recent research on Chiari Malformation Type I.

Contributors.

Philip A. Allen, James R. Houston, & Francis Loth

Leader and follower identity invention: The effect of primed social support.

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Event.

95th Annual Midwestern Psychological Association Conference

Abstract.

Leadership identities are important in many settings, such as: military, management, and politics. Leadership is a social construct reliant on followership as a social counterpart. Cognitive priming has been shown to affect leadership and followership identities, but the extent of these effects is unknown in current research. Leadership identities are thought to be fluid, fluctuating within the person and over time. The purpose of this study is to identify if priming social support versus social rejection affects the salient leadership identity, and the degree of which internal and external constraints modify associations identified in the former. The project will be to help establish factors that influence someone’s ability to become a leader in the moment. The methods used consist of a writing activity to prime participants, followed by a lexical decision task focused on words with leader or follower schemas, a prime-probe lexical decision task, and lastly using self-report data about participants focused on demographics, leadership and followership identity, internal and external constraints, self-regulatory focus, and adolescent leadership activities. We hypothesize that leadership identity will be stronger in individuals who have been primed with leadership schema words, but also that internal and external constraints will have a significant impact on if the priming affects the participants identity. Future research can investigate further how to prime individuals for leadership, particularly in workplace or military settings, to garner more effective results.

Contributors.

Erika Allen, Rachel Strong, Emily Maldonado, Denise M. Ealy, Elizabeth Key, Andrew Finch, Kendall Perssico, Carolina Wenefrieda Nieberle, James R. Houston

Leader and follower identity invention: The effect of identity priming.

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Event.

95th Annual Midwestern Psychological Association Conference

Abstract.

Purpose. Leadership qualities are highly desired across a multitude of settings including industry, academia, and the military. Recent findings suggest that leadership identities are dynamic and subject to influence by a several factors. For example, Lord and colleagues (2020) recently found that leadership schemas are sensitive to priming effects. In the present study, we examined whether the salience of leadership-associated stimuli could be modulated by priming leadership identities.

Procedure. Forty-two undergraduate participants completed a primed lexical decision task. The task consisted of 72 trials divided into two parts. The first part of each trial began with a forced response (yes/no) to one of two questions: (1) “Does this word describe you?”, or (2) “Would close others use this word to describe you?”. These prompts were followed by a leader-associated, follower-associated, or neutral word that completed the priming query. The second part of each trial consisted of a lexical decision task in which participants made determinations as to whether a string of letters represented a word or a word-like nonword (e.g., braffic). In this part, words were either leadership-associated (e.g., charismatic), or followership-associated (e.g., obey). Participants also completed a series of self-report assessments that provide data on demographics, leadership and followership identities, internal and external constraints, self-regulatory focus, and adolescent leadership activities.

Results. Identity salience was operationalized as response times for accurate responses in the lexical decision task. A 3 (priming condition) x 2 (probe condition) factorial analysis of variance was conducted with identity salience as the dependent variable. Results indicated that there was no priming condition by probe condition interaction, F(2,82) = 1.773, p = 0.176, partial eta sq = 0.041. There was also no main effect of prime condition, F(2,82) = 0.898, p = 0.411, partial eta sq = 0.021. However, there was a main effect for probe condition, F(1,42) = 9.244, p = 0.004, partial eta sq = 0.184. Leader probes (Mleader = 865ms) evoked faster response times compared to follower probes (Mfollower = 908ms). These analyses were complemented by examining whether self-reported tendencies to endorse leadership and followership prime queries were associated with response times during lexical decision. The relation between self-report assessments and identity salience measures were also explored.

Conclusions. We found partial support for the momentary modifiability of leadership identity. With more data, we will be able to further explore the dynamic nature of leadership identities and better inform leadership training programs.

Contributors.

Rachel Strong, Elizabeth Key, Erika Allen, Andrew Finch, Denise M. Ealy, Emily Maldonado, Kendall Perssico, & James R. Houston

Voxel-based morphometry analysis of grey matter in Chiari Malformation.

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Event.

95th Annual Midwestern Psychological Association Conference

Abstract.

Background/Purpose. Chiari malformation type I (CMI) is a neurological disorder in which the cerebellar tonsils extend into the spinal canal. Symptoms of CMI may include headaches, neck pain, and motor disturbances. Prior research also suggests CMI may result in cognitive dysfunction (I would change this to: Additionally, prior research studies have suggested a correlation between CMI and cognitive dysfunction.) Previous CMI imaging studies mainly focus have primarily focused on cerebellar tonsil measurement and position. The purpose of this study is to investigate structural differences in grey matter volumes between CMI patients and normal controls.

Methods. Voxel-based morphometry (VBM) was used utilized to examine voxel-wise differences in grey matter volumes of 18 CMI patients and 18 healthy controls. T1-weighted structural images were analyzed using FSL-VBM.

Results. CMI patients were found to have significantly greater grey matter volumes in the cerebellar tonsils compared to controls (p < 0.05). Several cognitive and behavioral measures were used as covariates to account for differences in grey matter volumes. The Neck Pain and Disability Index, Short-form McGill Pain Questionnaire, Quality of Life Scale, and the stress subscale of the Depression-Anxiety-Stress Scale each individually accounted for the differences in grey matter between the groups (p > 0.05). Of these four covariates, none were significantly related to morphometry within each group (p > 0.05).

Conclusions. Results of this study revealed differences in grey matter volumes in the cerebellar tonsils between CMI patients and healthy controls. Stress, pain, and quality of life were associated with the morphometric difference between groups. However, additional research is needed to fully understand the implications of these differences.

Contributors.

Denise M. Ealy, Christine A. Adalikwu, Kendall Perssico, Philip A. Allen, James R. Houston

Adult Age Differences in Pain in Chiari Malformation: The Mediating Effect of Decreasing Anterior CSF Area.

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Click through to the organization’s website

Event.

Bobby Jones CSF 2020 Fall Research Meeting

Topic.

This talk examines the dynamic relationships between aging, brain morphology, and symptomatology in adults with Type I Chiari Malformation

Contributors.

Maitane García, Maggie S. Eppelheimer, James R. Houston, Michelle L. Houston, Blaise Simplice Talla Nwotchouang, Kevin P. Kaut, Richard Labuda, Jayapalli Rajiv Bapuraj, Jahangir Maleki, Petra, M. Klinge, Sarel J. Vorster, Mark G. Luciano, Francis Loth, Philip A. Allen

Investigating the relationship between cognitive function and neural connectivity in Type I Chiari malformation patients

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Event.

Psychonomic Society Annual Meeting 2019

Abstract.

Type I Chiari malformations are structural dysmorphisms of the hindbrain and posterior cranial fossa that are associated with a multitude of symptoms including chronic occipital headache, muscle weakness, and vestibular disturbances. In the present study, 18 Chiari patients and 18 age- and gender- matched controls completed a neuropsychological battery (RBANS), self-report measures for pain and mental health, and underwent resting-state functional neuroimaging (rs-FMRI). Seed-based analysis revealed group differences in functional connectivity in several regions such that healthy controls displayed greater activation between cerebellar lobule IX and the anterior cingulate region as well as between lobule X and the left parahippocampal region. Chiari patients showed greater connectivity between the right PFC and superior frontal gyrus; meanwhile controls had greater connectivity between the right PFC and the frontal pole. Attention and pain associated with subsections of the default mode network (DMN) were found to explain some of these relationships.

Contributors.

Michelle L. Hughes, James R. Houston, Sarel J. Vorster, Mark G. Luciano, Francis Loth, Philip A. Allen

Creativity remains stable through 55 years of age.

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Event.

Psychonomics Society Annual Meeting 2019

Abstract.

Simonton (1984) proposed that creativity as defined by career productivity increases from younger to middle adulthood – peaking at 42 years of age and then decreasing (i.e., a quadratic effect of creativity). This model is based on a number of factors (although chance-configuration theory – see Simonton, 1997 – emphasizes processing speed, illustrated in Figure 1 using the solid line). We hypothesize that creative productivity is the inverse effect of inhibitory control (i.e., top-down attention control has a negative effect on creativity in this alternative model; see Figure 1 – dotted line). One concern using career productivity as one’s measure of creativity (as Simonton did) is that it does not look at creative potential—but rather creative accomplishments (e.g., the number of peer-reviewed journal articles). However, this approach is confounded with other variables such as the “service load” across academic careers (which tends to increase with chronological age) and the number of research fields in which faculty members are involved (e.g., I may begin my career studying episodic memory, switch to divided attention, and then study how individual differences affect divided attention—each new specialty would open up many new potential projects). We attempted to avoid such problems by using a cross-sectional design to test participants aged 18-54 years on objective tests of creativity: the Torrence Tests of Creative Thinking-Verbal (TTCT) and the Ruff Figural Fluency Test (RFFT).

Contributors.

Philip A. Allen, Kathy Lamancusa, James R. Houston, Michelle L. Hughes, Mei-Ching Lien

Exploring the current perspectives on cognitive and emotional aging: What does the research suggest about our aging minds?

Click through to conference website.

Click through to conference website

Event.

Annual meeting for the Middle Tennessee Psychological Association

Abstract.

If we have the good fortune, we will all age and experience age-related changes in our mental function. Yet, stereotypes for the aging brain are pervasive and generally paint a bleak picture of decline. I will review the current scientific understanding of the aging mind and the steps that are being taken by aging researchers to better understand how we can ward off age-related declines in mental function and maintain our mental capacities as we age.

To view the keynote presentation slides, please follow this link: (https://www.dropbox.com/s/vajiuplxv55pk9g/MTPA%20keynote.pptx?dl=0)

Contributors.

James R. Houston

Structural Integrity (DTI) and Functional Connectivity (Resting-State fMRI) in Chiari Malformation Type I: The Effects of Pain and Cognition.

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Click through to conference website.

Event.

2nd Annual CSF Flow Meeting

Abstract.

Background: We report DTI and resting-state fMRI results on a sample of adults diagnosed with Chiari malformation Type I (CM1) and eligible for decompression surgery and 18 age- and education-matched controls.  The most salient symptom of Chiari malformation Type I is chronic headache pain (Fischbein et al., 2015).  However, there is growing evidence of cognitive symptoms, as well (Allen et al., 2014, Garcia et al., 2018; Houston et al., in press; Rogers et al., 2018).  The goal of the present study was two-fold.  First, are there reliable group differences in structural integrity (DTI) and functional connectivity (resting-state fMRI)?  Second, if group differences in such fiber-tract effects occur, are they related to pain and cognitive effects?       

Methods: We scanned 18 CM1 individuals and 18 age- and education-matched controls using a 3T Siemens scanner with Prisma software.  All participants were also assessed on the McGill Pain Questionnaire-Short Form and the RBANS neuropsychological assessment battery.  

Results: We observed group differences in DTI fractional anisotropy (FA) and diffusivity (radial and mean) in regions of the cerebellum, cingulum, and cerebrum—and this was positively correlated with SF-MPQ scores (i.e., CM1 patients showed higher FA values than controls).  Also, controls showed a significant correlation between FA and radial diffusivity and RBANS Coding scores in brain regions that have been associated with the frontoparietal attentional pathway, but the was no significant correlation between diffusion paramters and Coding scores for CM1 patients.  For the functional connectivity analyses (resting-state fMRI), seed-based analysis  showed group differences in functional connectivity for Lobules IX and X, as well as the default mode network (both positive and negative) and frontoparietal attentional pathway.

Discussion and Conclusions: We observed both structural (DTI) and functional (resting-state fMRI) group differences. The cases in which CM1 patients had either higher FA or increased functional connectivity relative to controls were associated with self-reported pain levels. Alternatively, controls showed increases in FA as RBANS Coding scores increased (but no effect for CM1 patients). The implications for recent functional connectivity findings will also be discussed.

Contributors.

Philip A. Allen, James R. Houston, Michelle L. Hughes, Ilana J. Bennett, Francis Loth, Jeffrey M. Rogers, Marcus A. Stoodley, Mark G. Luciano, Sarel J. Voster

Comparison of Brain Morphology for Chiari I Malformation Subjects With and Without Ehlers-Danlos Syndrome.

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Click through to conference website.

Event.

2nd Annual CSF Flow Meeting

Abstract.

Background. Many patients with Chiari malformation type I (CM) also have Ehlers-Danlos syndrome (EDS). EDS is characterized as a connective tissue disorder with patients diagnosed demonstrating joint hypermobility and recurrent joint dislocations. Our Chiari1000 database shows that 9.4% of the CM subjects also have EDS (CM+EDS).  In addition, 26% score high (>4) on a hypermobility index (Beighton Scale). While there are differences between the biomechanical properties of connective tissue for people with CM+EDS and CM without EDS (CM-EDS), it is unclear if this translates to differences between brain morphology for CM+EDS compared to CM-EDS.

Methods. Midsagittal morphological characteristics of CM+EDS patients were evaluated by comparing 50 morphological measurements (MMs) within the intracranial and craniocervical regions on 245 adult female CM subjects with (n=31) and CM-EDS (n=214). Morphological differences were determined using a two-tailed independent t-test and a Mann-Whitney u-test.

Results. Cerebrospinal fluid area (CSF) below the foramen magnum anterior and posterior to the brainstem was 14% and 24% larger respectively in CM+EDS compared to CM-EDS (p < 0.001, Cohen’s d > 0.5).  Average tonsillar position was smaller for CM+EDS compared CM-EDS (5.3 and 7.8 mm, respectively with p < 0.05, Cohen’s d > 0.47). However, 35 of the 50 MMs showed less than 3% difference between the two groups.

Discussion and Conclusions. While most of the 50 MMs were not different between CM+EDS and CM-EDS groups, a trend was observed of reduced crowding in CM+EDS patients within the craniocervical region compared to CM-EDS. Overall, the morphometrics for CM+EDS subjects was not markedly different when compared to CM-EDS cases.

Contributors.

Maggie S. Eppelheimer, Dipankar Biswas, Jayapalli Rajiv Bapuraj, James R. Houston, Dorothy M. Loth, Richard Labuda, Philip A. Allen, Francis Loth

Aging and context effects in working memory: an event-related potential investigation

Event

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Psychonomics Society Annual Meeting 2018

Abstract

Older adults exhibit deficits in working memory function compared to younger adults. The goal of this multiple experiment study was to examine the role played by context integration in age-related differences in working memory performance. Behavioral and neurophysiological measures were taken while participants engaged in two tasks to address potential age group differences in working memory encoding, retrieval, and context integration. We observed an age-related reduction in resource reserves that led to losses when the older adults’ comparatively lower resource capacities were exceeded by task demands. ERP analyses suggested that these effects were associated with working memory access deficits with aging. Older adults also exhibited more diffuse, and frontal activations. We conclude that resource consumption is the most likely candidate to drive age group differences in working memory performance and that this difference is the result of age-related deficits in accessing offline working memory stores.

Contributors

James R. Houston, Mei-Ching Lien, Michelle L. Hughes, Peter R. Mallik, Philip A. Allen

Creating the Creative: What Distinguishes Creative Older Adults?

Event

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Psychonomics Society Annual Meeting 2018

Abstract

 Fifty older adults (25 female and 25 male) and 50 younger adults (29 females and 21 males) were tested using a creativity assessment (Torrance Test of Creative Thinking – verbal), broken into three subscores (fluency, flexibility, and originality) and several inhibitory control and executive function measures (Stroop task, flanker task, Barratt Impulsiveness Scale – 11). Results indicated no age differences in creativity scores despite differences in congruency effects favoring younger adults for the Stroop task. There was an effect of gender on creativity scores, such that women outperformed men on all subscores of creativity. Furthermore, when examining these gender differences in each respective group, the gender effect was only persistent in the older adult group. These results suggest that there may be an underlying cognitive advantage for females, especially older females, that facilitates creative performance that remains to be explored.

Contributors

Michelle L. Hughes, Philip A. Allen, Sara Lute, James R. Houston

Investigating Neurological Correlates of Chiari Malformation Type I Symptomatology: A Diffusion Tensor Imaging Study of Cognition and Pain

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Event

Psychonomics Society Annual Meeting 2017

Abstract

18 Chiari patients (CMI) and 18 matched control participants were tested using a neuropsychological assessment (RBANS), completed self-report measures of pain and mental health, and underwent diffusion-weighted (DTI) scan sequences. Diffusion indices of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were extracted from standardized space.

CMI patients exhibited greater FA, and reduced RD and MD relative to control participants, localized to inferior antero-posterior white matter pathways. In both groups, FA was negatively correlated the the attention subscale of the RBANS and positively associated with pain, anxiety, and stress. RD and MD were negatively associated with pain and stress. RD in CMI patients, but not control participants, was negatively associated with overall performance on the RBANS. These results suggest that compression of white matter tracts, likely due to the chronic inflammatory response exhibited by many CMI patients, potentially accounts for the cognitive dysfunction observed in CMI.

Contributors

Michelle L. Hughes, James R. Houston, Mei-Ching Lien, Ilana J. Bennett, Sarel G. Vorster, Mark G. Luciano, Francis Loth, Philip A. Allen

Proposal of a "Cerebellar" Cognitive Test Battery-Adult Perspective

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Click to navigate to program description

Event

2nd Annual CSF Disorders Symposium: Chiari and Cognition - Fiction or Reality?

Educational Objectives

  • Identify cognitive tasks associated with cerebellar function-especially Chiari Malformation Type I

  • Explain standardized versus experimental tasks assessing cognition and why this is important

  • Describe the relationship between RBANS performance and morphometric measures in Chiari Malformation Type I

Contributors

Philip A. Allen, James R. Houston, Michelle L. Hughes

A Multi-Disciplinary Approach to the Study of Type I Chiari Malformation

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Event

Winter Conference on Brain Research 2017

Abstract

Type I Chiari malformation (CM) is a structural defect where part of the cerebellum is located below the foramen magnum. Characterized by NIH, individuals with CM may complain of neck pain, balance problems, muscle weakness, numbness in the arms or legs, dizziness or headache made worse by coughing or straining. Symptoms may change for some individuals, depending on the buildup of CSF and resulting pressure on the tissues and nerves. Thus, a basic understanding of the pathogenesis of CM has been elusive. Our group at the Conquer Chiari Research Center has been working towards a better understanding of CM through a multidisciplinary approach. The four areas of investigation are imaging, cognitive processes, psycho-social function, and assessments of the inflammatory response. We have developed projects to examine these four areas by creating a web-accessed, secure database called Chiari1000. Chiari1000 collects health-related, neuropsychological, and MR scans voluntarily provided by Chiari patients. Cognitive processes and psycho-social function are assessed through a series of web surveys. To assess the inflammatory response, blood assays are obtained through local Quest Diagnostics clinics, and saliva samples are provided through the mail. The Chiari1000 registry launched in the Fall 2015. Presently, 708 CMI participants have completed surveys (with 314 MR images). We hope to obtain 1000 CMI subjects with completed surveys and corresponding MRIs and the inflammatory response on 100 of these subjects. We have developed custom software for automated morphological measurements, data visualization, and analysis of these multidisciplinary results. This information may help to stratify CM patients which will help in the development of new hypotheses for this complex condition. The overall goal is to identify novel objective measures that are predictive of symptom severity to help in the diagnosis of CM and the evaluation of various treatment options.

Contributors

Francis Loth, James R. Houston, Dipankar Biswas, Soroush Pahlavian, Maggie Eppelheimer, Dorothy Loth, Richard Labuda, Philip A. Allen

Brain Morphometrics that Provide a Better Understanding of Chiari Type I Malformation

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Event

Summer Biomechanics, Bioengineering and Biotransport Conference 2017

Introduction Excerpt

Through examination of MR images, additional brain and cranial structures have been shown to differ significantly between CMI patients and healthy individuals. In previous studies, a reduced posterior cranial fossa (PCF) is the principal attribute of CMI [3]. Yet, other studies did not find a relationship between PCF area and CMI [4].

The main objective for this study was to determine additional parameters aside from TP that differentiate between CMI patients and healthy controls, with the potential to improve diagnosis and prognosis of this disorder. A subset of these parameters located within the PCF compartment will be discussed within this abstract.

Contributors

Maggie S. Eppelheimer, James R. Houston, Soroush Heidari Pahlavian, Audrey M. Braun, Dipankar Biswas, Dorothy M. Loth, Aintzane Urbizu, Richard Labuda, Philip A. Allen, Francis Loth

Morphometric Analysis of Cerebellum in Type 1 Chiari Malformation

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Event

Summer Biomechanics, Bioengineering and Biotransport Conference 2017

Introduction Excerpt

Type I Chiari malformation (CMI) is a neurological disorder of the hindbrain in which the position of cerebellum is lower in the brain which could serve as an obstruction to cerebrospinal fluid motion. CMI patients present a wide range of symptoms that can vary from pain in the head and neck, dizziness or impaired cognitive functions. It is radiologically identified by the position of the cerebellar tonsils to be three to five millimeters below the foramen magnum. The goal of the present study is to determine what cerebellum morphometric parameters beyond the tonsillar herniation are different for CMI patients as compared to healthy controls..

Contributors

Dipankar Biswas, Maggie. S. Eppelheimer, James R. Houston, Audrey Braun, Richard Labuda, Francis Loth

Alexithymia in Men? An Electrophysiological Investigation of Emotional Processing

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Event

Psychonomics Society Annual Meeting 2016

Abstract

The Normative Male Alexithymia Hypothesis proposes that men may have more difficulty in displaying emotion—especially vulnerable emotions such as fear (Levant, 1992).  Specifically, Alexithymics may exhibit emotional recognition deficits—especially for angry faces (hypothesized to arouse fear) relative to happy faces.  Also, early repression (unconscious avoidance) and later suppression (conscious avoidance) loci were assessed using P1 and P3 (measured 100-200 and 400-700 ms after stimulus presentation, respectively) event-related potentials (ERPs). We tested 15 male subjects who scored above the90th percentile rank on the Toronto Alexithymia Scale (TAS-20), and 15 male controls with average scores, on a facial emotion recognition task (happy, angry or neutral ).  The ERP results indicated that individuals who scored high on the TAS-20 showed significantly lower P1 and P3 amplitudes on all emotional faces than those individuals who scored in the average range.  Also, the control group showed relatively higher amplitudes for negatively valenced stimuli than for neutral stimuli, whereas the “Alexithymic” group showed the reverse trend.  This suggests that Alexithymic symptomology may stem from both early (perceptual) and later (cognitive) inhibition of vulnerable emotions.

Contributors

Elliott Jardin, Philip A. Allen, Ronald F. Levant, Mei-Ching Lien, Erik McCurdy, Anthony Villalba, James R. Houston

Chiari Malformation and Hyper-Vigilance: An EEG Study

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Event

Psychonomics Society Annual Meeting 2016

Abstract

We tested 15 Chiari patients and 12 controls on an attentional dual-task (Task 1: tone discrimination, Task 2: emotional face discrimination task using angry, happy, and neutral faces) that varied stimulus onset asynchrony (SOA: 100, 300, and 900 ms).  Chiari malformation Type I is a neurological syndrome in which the cerebellar tonsils descend into the cervical spine area resulting in cervicomedullary compression (i.e., the brainstem is compressed).  Common symptoms are chronic headaches and balance problems.  We collected P100 and P300 ERP components (measured from 100-200 ms, and 400-600 ms, respectively, after Stimulus 2 presentation) at electrode sites O1 and O2, and Pz, respectively.  We observed no group differences in either SOA (a measure of attentional capacity) or emotional valence.  However, Chiari patients showed significantly higher-amplitude P100 components (but not P300 components) than controls.  These results are consistent with a hyper-vigilance effect in the ventral attentional stream for the Chiari group.        

Contributors

James R. Houston, Philip A. Allen, Mark G. Luciano, Sarel J. Vorster, Francis Loth