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ORIGINAL RESEARCH article

Front. Neuroanat.
Volume 18 - 2024 | doi: 10.3389/fnana.2024.1434017

Geometric Morphometric Analysis of the Brainstem and Cerebellum in Chiari I Malformation

Provisionally accepted
Ishan R. Perera Ishan R. Perera Malek Zahed Malek Zahed Sydney Moriarty Sydney Moriarty Zachary Simmons Zachary Simmons Maya Rodriguez Maya Rodriguez Courtney Botkin Courtney Botkin Taylor Dickson Taylor Dickson Bradley Kasper Bradley Kasper Kendyl Fahmy Kendyl Fahmy Jonathan A. Millard Jonathan A. Millard *
  • The Edward Via College of Osteopathic Medicine (VCOM), Auburn, Virginia, United States

The final, formatted version of the article will be published soon.

    Chiari I malformation (CMI) is characterized by inferior descent of the cerebellar tonsils through the foramen magnum and is associated with headache and neck pain. Many morphometric research efforts have aimed to describe CMI anatomy in the midsagittal plane using classical measurement techniques such as linear dimensions and angles. These methods are less frequently applied to parasagittal features and may fall short in quantifying more intricate anatomy with fewer distinct homologous landmarks. Here we assess CMI morphology utilizing geometric morphometric techniques with semilandmarks in five planes of anatomical interest. Significant shape differences between CMI and age/sex-matched controls were found in the midsagittal (Pseudo-F = 5.4841, p = .001) and axial planes through the rostral medulla (Pseudo-F = 7.6319, p = .001). In addition to tonsillar descent, CMI principal component 1 (PC1) scores in the midsagittal protocol were associated with marked anterior concavity of the brainstem and generalized verticality of the cerebellum with anterior rotation of its anterior lobe. In the axial medulla/cerebellum protocol, CMI PC1 scores were associated with greater anterior-posterior (A-P) dimension with loss of medial-lateral (M-L) dimension. These results suggest that CMI is associated with greater curvature of the brainstem and spinal cord, which may perturb normal neural activities and disrupt cerebrospinal fluid movements. Previous reports on the A-P diameter of the posterior fossa in CMI have conflicted; our findings of greater A-P cerebellar dimensionality with concomitant loss of width alludes to the possibility that more caudal aspects of the posterior cranial fossa are more bowl-like (homogenous in axial dimensions) and less trough-like or elongated in the M-L direction.

    Keywords: Arnold - Chiari malformation, Geometric morphometric analysis, Neck Pain, Foramen Magnum, Posterior cranial fossa

    Received: 16 May 2024; Accepted: 24 Jul 2024.

    Copyright: © 2024 Perera, Zahed, Moriarty, Simmons, Rodriguez, Botkin, Dickson, Kasper, Fahmy and Millard. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jonathan A. Millard, The Edward Via College of Osteopathic Medicine (VCOM), Auburn, Virginia, United States

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