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Superficial abdominal reflex in syringomyelia: Associations with Chiari I malformation
•In the largest cohort of patients studied to date with syrinx and evaluation for superficial abdominal reflex (SAR), we show that an abnormal SAR is more common in Chairi-associated syrinx, compared with idiopathic syrinx (P
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| Published in: | Journal of clinical neuroscience 2022-04, Vol.98, p.1-5 |
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| creator | Nadel, Jeffrey L. Ziats, Catherine Mossner, James M. Starr, Jordan B. Smith, Brandon W. Kelly, Michael P. Muraszko, Karin M. Farley, Frances A. Maher, Cormac O. Garton, Hugh J.L. Strahle, Jennifer M. |
| description | •In the largest cohort of patients studied to date with syrinx and evaluation for superficial abdominal reflex (SAR), we show that an abnormal SAR is more common in Chairi-associated syrinx, compared with idiopathic syrinx (P |
| doi_str_mv | 10.1016/j.jocn.2021.12.037 |
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An abnormal or absent superficial abdominal reflex (SAR) may be associated with an underlying spinal cord syrinx. The sensitivity of an abnormal or absent SAR and the relationship to Chiari malformation type I (CM-I) or syrinx morphology has not been studied. We aimed to describe the relationship between SAR abnormalities and syrinx size, location, and etiology. Children who underwent brain or c-spine MRI over 11 years were reviewed in this retrospective cohort study. Patients with idiopathic and CM-I–associated syringes (axial diameter ≥ 3 mm) were included. Clinical examination findings (including SAR) and imaging characteristics were analyzed. Of 271 patients with spinal cord syrinx, 200 had either CM-I–associated or idiopathic syrinx, and 128 of these patients had SAR-evaluation documentation. Forty-eight percent (62/128) had an abnormal or absent reflex. Abnormal/absent SAR was more common in patients with CM-I–associated syrinx (61%) compared with idiopathic syrinx (22%) (P < 0.0001). Abnormal/absent SAR was associated with wider syringes (P < 0.001), longer syringes (P < 0.05), and a more cranial location of the syrinx (P < 0.0001). Controlling for CM-I, scoliosis, age, sex, cranial extent of syrinx, and syrinx dimensions, CM-I was independently associated with abnormal or absent SAR (OR 4.2, 95% CI 1.4–14, P < 0.01). Finally, the sensitivity of SAR for identifying a patient with syrinx was 48.1%. An abnormal/absent SAR was present in most patients with CM-I–associated syrinx but in a minority of patients with idiopathic syrinx. This has implications for pathophysiology of CM-I–associated syrinx and in guiding clinical care of patients presenting with syrinx.]]></description><identifier>ISSN: 0967-5868</identifier><identifier>EISSN: 1532-2653</identifier><identifier>DOI: 10.1016/j.jocn.2021.12.037</identifier><identifier>PMID: 35114475</identifier><language>eng</language><publisher>Scotland: Elsevier Ltd</publisher><subject>Arnold-Chiari Malformation - complications ; Arnold-Chiari Malformation - diagnostic imaging ; Chiari ; Child ; Humans ; Magnetic Resonance Imaging - adverse effects ; Reflex, Abdominal - physiology ; Reflex, Abnormal ; Retrospective Studies ; Scoliosis ; Scoliosis - etiology ; Spinal cord ; Superficial abdominal reflex ; Syringomyelia - complications ; Syringomyelia - diagnostic imaging ; Syrinx</subject><ispartof>Journal of clinical neuroscience, 2022-04, Vol.98, p.1-5</ispartof><rights>2022 Elsevier Ltd</rights><rights>Copyright © 2022 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-bfd808a322ce8cd745caaaff40c0ac4dddde9ed160009586c8b2c9fd4594d01c3</citedby><cites>FETCH-LOGICAL-c356t-bfd808a322ce8cd745caaaff40c0ac4dddde9ed160009586c8b2c9fd4594d01c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35114475$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nadel, Jeffrey L.</creatorcontrib><creatorcontrib>Ziats, Catherine</creatorcontrib><creatorcontrib>Mossner, James M.</creatorcontrib><creatorcontrib>Starr, Jordan B.</creatorcontrib><creatorcontrib>Smith, Brandon W.</creatorcontrib><creatorcontrib>Kelly, Michael P.</creatorcontrib><creatorcontrib>Muraszko, Karin M.</creatorcontrib><creatorcontrib>Farley, Frances A.</creatorcontrib><creatorcontrib>Maher, Cormac O.</creatorcontrib><creatorcontrib>Garton, Hugh J.L.</creatorcontrib><creatorcontrib>Strahle, Jennifer M.</creatorcontrib><title>Superficial abdominal reflex in syringomyelia: Associations with Chiari I malformation</title><title>Journal of clinical neuroscience</title><addtitle>J Clin Neurosci</addtitle><description><![CDATA[•In the largest cohort of patients studied to date with syrinx and evaluation for superficial abdominal reflex (SAR), we show that an abnormal SAR is more common in Chairi-associated syrinx, compared with idiopathic syrinx (P < 0.0001).•In our cohort of patients with idiopathic and Chiari-associated syrinx, the overall sensitivity of SAR for spinal cord syrinx was 48%.•After controlling for sex, age, syrinx size, syrinx location, scoliosis and presence of Chiari, the presence of Chiari was independently associated with an abnormal or absent SAR in patients with syrinx (OR 4.2, 95% CI 1.4–14, P < 0.01).•Patients with scoliosis were more likely to have an abnormal or absent SAR (P = 0.016).•These findings have implications for the pathophysiology of Chiari-associated and idiopathic syrinx and in the management of patients presenting with syrinx.
An abnormal or absent superficial abdominal reflex (SAR) may be associated with an underlying spinal cord syrinx. The sensitivity of an abnormal or absent SAR and the relationship to Chiari malformation type I (CM-I) or syrinx morphology has not been studied. We aimed to describe the relationship between SAR abnormalities and syrinx size, location, and etiology. Children who underwent brain or c-spine MRI over 11 years were reviewed in this retrospective cohort study. Patients with idiopathic and CM-I–associated syringes (axial diameter ≥ 3 mm) were included. Clinical examination findings (including SAR) and imaging characteristics were analyzed. Of 271 patients with spinal cord syrinx, 200 had either CM-I–associated or idiopathic syrinx, and 128 of these patients had SAR-evaluation documentation. Forty-eight percent (62/128) had an abnormal or absent reflex. Abnormal/absent SAR was more common in patients with CM-I–associated syrinx (61%) compared with idiopathic syrinx (22%) (P < 0.0001). Abnormal/absent SAR was associated with wider syringes (P < 0.001), longer syringes (P < 0.05), and a more cranial location of the syrinx (P < 0.0001). Controlling for CM-I, scoliosis, age, sex, cranial extent of syrinx, and syrinx dimensions, CM-I was independently associated with abnormal or absent SAR (OR 4.2, 95% CI 1.4–14, P < 0.01). Finally, the sensitivity of SAR for identifying a patient with syrinx was 48.1%. An abnormal/absent SAR was present in most patients with CM-I–associated syrinx but in a minority of patients with idiopathic syrinx. This has implications for pathophysiology of CM-I–associated syrinx and in guiding clinical care of patients presenting with syrinx.]]></description><subject>Arnold-Chiari Malformation - complications</subject><subject>Arnold-Chiari Malformation - diagnostic imaging</subject><subject>Chiari</subject><subject>Child</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging - adverse effects</subject><subject>Reflex, Abdominal - physiology</subject><subject>Reflex, Abnormal</subject><subject>Retrospective Studies</subject><subject>Scoliosis</subject><subject>Scoliosis - etiology</subject><subject>Spinal cord</subject><subject>Superficial abdominal reflex</subject><subject>Syringomyelia - complications</subject><subject>Syringomyelia - diagnostic imaging</subject><subject>Syrinx</subject><issn>0967-5868</issn><issn>1532-2653</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kEtPwzAQhC0EoqXwBzigHLkk2M7LQVyqikelShx4XC3H3lBHSVzsBOi_x6GFI3vxSv5mtDMInRMcEUyyqzqqjewiiimJCI1wnB-gKUljGtIsjQ_RFBdZHqYsYxN04lyNMS6SGB-jSZwSkiR5OkWvT8MGbKWlFk0gSmVa3fnNQtXAV6C7wG2t7t5Mu4VGi-tg7pzxbK9N54JP3a-DxVoLq4Nl0IqmMrb9-TtFR5VoHJzt3xl6ubt9XjyEq8f75WK-CmWcZn1YVophJmJKJTCp8iSVQoiqSrDEQibKDxSgSDae7oNIVlJZVCpJi0RhIuMZutz5bqx5H8D1vNVOQtOIDszgOM2o1xasYB6lO1Ra45wPyDdWt8JuOcF87JPXfOyTj31yQrnv04su9v5D2YL6k_wW6IGbHQA-5YcGy53U0ElQ2oLsuTL6P_9vGu2ItA</recordid><startdate>202204</startdate><enddate>202204</enddate><creator>Nadel, Jeffrey L.</creator><creator>Ziats, Catherine</creator><creator>Mossner, James M.</creator><creator>Starr, Jordan B.</creator><creator>Smith, Brandon W.</creator><creator>Kelly, Michael P.</creator><creator>Muraszko, Karin M.</creator><creator>Farley, Frances A.</creator><creator>Maher, Cormac O.</creator><creator>Garton, Hugh J.L.</creator><creator>Strahle, Jennifer M.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202204</creationdate><title>Superficial abdominal reflex in syringomyelia: Associations with Chiari I malformation</title><author>Nadel, Jeffrey L. ; Ziats, Catherine ; Mossner, James M. ; Starr, Jordan B. ; Smith, Brandon W. ; Kelly, Michael P. ; Muraszko, Karin M. ; Farley, Frances A. ; Maher, Cormac O. ; Garton, Hugh J.L. ; Strahle, Jennifer M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-bfd808a322ce8cd745caaaff40c0ac4dddde9ed160009586c8b2c9fd4594d01c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Arnold-Chiari Malformation - complications</topic><topic>Arnold-Chiari Malformation - diagnostic imaging</topic><topic>Chiari</topic><topic>Child</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging - adverse effects</topic><topic>Reflex, Abdominal - physiology</topic><topic>Reflex, Abnormal</topic><topic>Retrospective Studies</topic><topic>Scoliosis</topic><topic>Scoliosis - etiology</topic><topic>Spinal cord</topic><topic>Superficial abdominal reflex</topic><topic>Syringomyelia - complications</topic><topic>Syringomyelia - diagnostic imaging</topic><topic>Syrinx</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nadel, Jeffrey L.</creatorcontrib><creatorcontrib>Ziats, Catherine</creatorcontrib><creatorcontrib>Mossner, James M.</creatorcontrib><creatorcontrib>Starr, Jordan B.</creatorcontrib><creatorcontrib>Smith, Brandon W.</creatorcontrib><creatorcontrib>Kelly, Michael P.</creatorcontrib><creatorcontrib>Muraszko, Karin M.</creatorcontrib><creatorcontrib>Farley, Frances A.</creatorcontrib><creatorcontrib>Maher, Cormac O.</creatorcontrib><creatorcontrib>Garton, Hugh J.L.</creatorcontrib><creatorcontrib>Strahle, Jennifer M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical neuroscience</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nadel, Jeffrey L.</au><au>Ziats, Catherine</au><au>Mossner, James M.</au><au>Starr, Jordan B.</au><au>Smith, Brandon W.</au><au>Kelly, Michael P.</au><au>Muraszko, Karin M.</au><au>Farley, Frances A.</au><au>Maher, Cormac O.</au><au>Garton, Hugh J.L.</au><au>Strahle, Jennifer M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Superficial abdominal reflex in syringomyelia: Associations with Chiari I malformation</atitle><jtitle>Journal of clinical neuroscience</jtitle><addtitle>J Clin Neurosci</addtitle><date>2022-04</date><risdate>2022</risdate><volume>98</volume><spage>1</spage><epage>5</epage><pages>1-5</pages><issn>0967-5868</issn><eissn>1532-2653</eissn><abstract><![CDATA[•In the largest cohort of patients studied to date with syrinx and evaluation for superficial abdominal reflex (SAR), we show that an abnormal SAR is more common in Chairi-associated syrinx, compared with idiopathic syrinx (P < 0.0001).•In our cohort of patients with idiopathic and Chiari-associated syrinx, the overall sensitivity of SAR for spinal cord syrinx was 48%.•After controlling for sex, age, syrinx size, syrinx location, scoliosis and presence of Chiari, the presence of Chiari was independently associated with an abnormal or absent SAR in patients with syrinx (OR 4.2, 95% CI 1.4–14, P < 0.01).•Patients with scoliosis were more likely to have an abnormal or absent SAR (P = 0.016).•These findings have implications for the pathophysiology of Chiari-associated and idiopathic syrinx and in the management of patients presenting with syrinx.
An abnormal or absent superficial abdominal reflex (SAR) may be associated with an underlying spinal cord syrinx. The sensitivity of an abnormal or absent SAR and the relationship to Chiari malformation type I (CM-I) or syrinx morphology has not been studied. We aimed to describe the relationship between SAR abnormalities and syrinx size, location, and etiology. Children who underwent brain or c-spine MRI over 11 years were reviewed in this retrospective cohort study. Patients with idiopathic and CM-I–associated syringes (axial diameter ≥ 3 mm) were included. Clinical examination findings (including SAR) and imaging characteristics were analyzed. Of 271 patients with spinal cord syrinx, 200 had either CM-I–associated or idiopathic syrinx, and 128 of these patients had SAR-evaluation documentation. Forty-eight percent (62/128) had an abnormal or absent reflex. Abnormal/absent SAR was more common in patients with CM-I–associated syrinx (61%) compared with idiopathic syrinx (22%) (P < 0.0001). Abnormal/absent SAR was associated with wider syringes (P < 0.001), longer syringes (P < 0.05), and a more cranial location of the syrinx (P < 0.0001). Controlling for CM-I, scoliosis, age, sex, cranial extent of syrinx, and syrinx dimensions, CM-I was independently associated with abnormal or absent SAR (OR 4.2, 95% CI 1.4–14, P < 0.01). Finally, the sensitivity of SAR for identifying a patient with syrinx was 48.1%. An abnormal/absent SAR was present in most patients with CM-I–associated syrinx but in a minority of patients with idiopathic syrinx. This has implications for pathophysiology of CM-I–associated syrinx and in guiding clinical care of patients presenting with syrinx.]]></abstract><cop>Scotland</cop><pub>Elsevier Ltd</pub><pmid>35114475</pmid><doi>10.1016/j.jocn.2021.12.037</doi><tpages>5</tpages></addata></record> |
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| subjects | Arnold-Chiari Malformation - complications Arnold-Chiari Malformation - diagnostic imaging Chiari Child Humans Magnetic Resonance Imaging - adverse effects Reflex, Abdominal - physiology Reflex, Abnormal Retrospective Studies Scoliosis Scoliosis - etiology Spinal cord Superficial abdominal reflex Syringomyelia - complications Syringomyelia - diagnostic imaging Syrinx |
| title | Superficial abdominal reflex in syringomyelia: Associations with Chiari I malformation |
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