Chiari Registry Project: Assessment of Surgical Outcome on Self-Focused Attention, Pain and Delayed Recall - (in press)

Abstract

Background: Prior research has typically found a negative relationship between chronic pain and memory, and we examined whether cognitive control processes (e.g., reflection and rumination) moderated this relationship in individuals with Chiari malformation Type I (CM). CM is a neurological condition in which the cerebellar tonsils descend into the medullary and upper cervical spine regions potentially resulting in severe headaches and neck pain.
Methods: CM patients who had (n=341) and had not (n=297) undergone decompression surgery completed the McGill Pain Questionnaire-Short Form-Revised (SF-MPQ-2), the Rey Auditory Verbal Learning Test (RAVLT), and the Rumination-Reflection Questionnaire (RRQ). Immediate recall scores were compared to those of 102 healthy controls, and delayed recall performance was compared across other variables within the CM group.

Results: CM patients performed more poorly on immediate recall than did controls. Within CM patients, we observed main effects for reflection and age, and a Pain x Reflection x Surgical Status (surgery vs. no surgery) interaction in which non-decompressed individuals with low levels of pain and high levels of reflection showed superior delayed recall relative to non- decompressed individuals with higher pain and all decompressed individuals.

Conclusions: CM patients show an immediate recall deficit relative to controls, regardless of surgical status. Also, high levels of reflection were associated with better delayed recall performance in non-decompressed CM patients with lower pain levels. High levels of chronic pain may overwhelm increased focused attention abilities, but higher levels of reflection partially overcome the distracting effects of pain and this may represent a type of resilience. 

Contributors

Philip A. Allen, Douglas Delahanty, Kevin P. Kaut, Xuan Li, Monica Garcia, James R. Houston, David M. Tokar, Francis Loth, Jahangir Maleki, Sarel Vorster, Mark G. Luciano

Publication

Psychological Medicine

A Morphometric Assessment of type I Chiari Malformation above the McRae line: A Retrospective Case-Control Study in 302 Adult Female Subjects

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Thank you to Audrey Braun for her hard work on this project.

Abstract

Purpose. Type I Chiari malformation (CMI) is a radiologically-defined structural dysmorphism of the hindbrain and posterior cranial fossa (PCF). Traditional radiographic identification of CMI relies on the measurement of the cerebellar tonsils in relation to the foramen magnum with or without associated abnormalities of the neuraxis. The primary goal of this retrospective study was to comprehensively assess morphometric parameters above the McCrea line in a group of female CMI patients and normal controls.

Material and Methods. 29 morphological measurements were taken on 302 mid-sagittal MR images of adult female CMI patients (N=162) and healthy controls (N=140).  All MR images were voluntarily provided by CMI subjects through an online database and control participant images were obtained through the Human Connectome Project and a local hospital system. 

Results. Analyses were performed on the full dataset of adult female MR images and a restricted dataset of 229 participants that were equated for age, race, and body mass index. 18 group differences were identified in the PCF area that grouped into three clusters; PCF structures heights, clivus angulation, and odontoid process irregularity. 14 group differences persisted after equating CMI and control groups on demographic characteristics. 

Conclusion. PCF structures reliably differ in adult female CMI patients relative to healthy controls. These differences reflect structural abnormalities in the osseous and soft tissue structures of the clivus, odontoid process, and cerebellum. Clinical and pathophysiological implications are discussed.

Contributors

James R. Houston, Maggie S. Eppelheimer, Soroush Heidari Pahlavian, Dipankar Biswas, Aintzane Urbizu, Bryn A. Martin, Jayapalli Rajiv Bapuraj, Mark Luciano, Philip A. Allen, Francis Loth

Publication

Journal of Neuroradiology

Emotional Arousal Deficit or Emotional Regulation Bias? An Electrophysiological Study of Age-Related Differences in Emotion perception (in press)

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Thank you to Ann Rossmiller and Elizabeth Walker for your contributions to this project!

Abstract

Background/Study Context: Adult age differences in emotion processing have been attributed to age-related decline in earlier emotional perception and age-related bias in later emotional regulation. Yet, the relationship between the processes of early emotion perception and bias in emotional regulation and their influence on behavioral outcomes remains unclear. Event-related potentials (ERPs) have the temporal precision to allow for the online measure of neurophysiological activity and provide potential insight into the complex dynamics of emotion processing and aging.

Methods: ERPS were used as the primary measure to examine the hypotheses that younger adults will differ in emotional arousal and emotional bias as represented by the early P1 waveform and later P3 waveform, respectively. Thirty-two younger and older adults (16 each) performed a facial emotion discrimination task in which they identified standardized angry, happy, or neutral expressions of faces from the NimStim database (Tottenham et al., 2009).

Results: Younger adults showed a greater P1 ERP for angry faces relative to happy faces at parietal channels, while older adults did not exhibit any emotional modulation of the P1. In contrast, both younger and older adults showed a greater late P3 ERP for angry faces compared to happy faces.

Conclusion: Our results provide evidence for an age-related deficit in early emotion perception and autonomic arousal. Younger adults, but not older adults, exhibited a pattern of neurophysiological activity believed to reflect preconscious and reflexive identification of threat (Vuilleumier, 2005). Despite these age group differences in early emotion processing, younger and older adults did not exhibit differences in neurophysiological processes believed to reflect emotion regulation.

Contributors

James R. Houston, Joshua W. Pollock, Mei-Ching Lien, Philip A. Allen

Publication

Experimental Aging Research

Visual Acuity does not Moderate Effect Sizes of Higher-Level Cognitive Tasks

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Quick Note

Thank you again to Lani Bennett and Dave Madden for their patience with this project that was several years in making!

Abstract

Background: Declining visual capacities in older adults have been posited as a driving force behind adult age differences in higher-order cognitive functions (e.g., the “common cause” hypothesis of Lindenberger & Baltes, 1994). McGowan, Patterson and Jordan (2013) also found that a surprisingly large number of published cognitive aging studies failed to include adequate measures of visual acuity. However, a recent meta-analysis of three studies (LaFleur & Salthouse, 2014) failed to find evidence that visual acuity moderated or mediated age differences in higher-level cognitive processes. In order to provide a more extensive test of whether visual acuity moderates age differences in higher-level cognitive processes, we conducted a more extensive meta-analysis of topic.
Methods: Using results from 456 studies, we calculated effect sizes for the main effect of age across four cognitive domains (attention, executive function, memory, and perception/language) separately for five levels of visual acuity criteria (no criteria, undisclosed criteria, self-reported acuity, 20/80-20/31, and 20/30 or better).
Results: As expected, age had a significant effect on each cognitive domain. However, these age effects did not further differ as a function of visual acuity criteria.
Conclusion: The current meta-analytic, cross-sectional results suggest that visual acuity is not significantly related to age group differences in higher-level cognitive performance—thereby replicating LaFleur and Salthouse (2014). Further efforts are needed to determine whether other measures of visual functioning (e.g. contrast sensitivity, luminance) affect age differences in cognitive functioning. 

Contributors

James R. Houston, Ilana J. Bennett, David, Philip A. Allen, David J. Madden

Publication

Experimental Aging Research

Is Everybody Doing It? Perceptions and Misperceptions of Sexual Behavior in the College Freshman Population

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Quick Note

A big thank you to both Alex Zelin and Mindy Erchull for allowing me the opportunity to work with your dataset as well as your patience in providing background of the subject matter!

Abstract

Descriptive and injunctive norms have been shown to influence people’s perceptions of what actions are considered appropriate, but they are frequently based on misperceptions. Men and women often hold varying perceptions with regards to sexual attitudes and behaviors. One hundred fifty-six heterosexual freshman women and 135 heterosexual freshman men were surveyed about their own sexually permissive attitudes and behaviors and their perceptions of their best friend’s and the average same-sex freshman’s attitudes and behaviors. We antici- pated and found that women and men perceived a three-tiered significant difference in sexually permissive attitudes, with participants reporting the least permissive attitudes while reporting the perception that the average freshman had the most permissive attitudes. Differing results were found for the tiered differences for sexual intercourse and giving and receiving oral sex. In general, women’s own number of sexual partners was related to their own sexually permissive attitudes and their perceptions of others’ attitudes and behaviors. In contrast, men’s own number of sexual partners was typically only influenced by their own sexually permissive attitudes and their perceptions of other men’s behaviors. Ultimately, women’s behaviors are influenced by perceptions of others’ actions and beliefs in addition to their own beliefs, whereas men’s behaviors are influenced only by their own beliefs and their perceptions of others’ behaviors. 

Contributors

Alexandra I. Zelin, Mindy J. Erchull, James R. Houston

Publication

Gender Issues

Task-Specific and General Cognitive Effects in Chiari Malformation Type I

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A special thank you to Ann Rossmiller and Elizabeth Walker for their assistance with data collection!

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.
Design and 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.
Conclusion: 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. 

Contributors

Philip A. Allen, James R. Houston, Joshua W. Pollock, Chistopher Buzzelli, Xuan Li, A. Katherine Harrington, Bryn A. Martin, Francis Loth, Mei-Ching Lien, Jahangir Maleki, Mark G. Luciano.

Publication

PLoS One