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Imaging and health metrics in incidental cerebellar tonsillar ectopia: findings from the Adolescent Brain Cognitive Development Study (ABCD)

  • Paediatric Neuroradiology
  • Published:
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Abstract

Purpose

Incidental cerebellar tonsillar ectopia (ICTE) that meets the radiographic criterion for Chiari malformation type I (CMI) is an increasingly common finding in the clinical setting, but its significance is unclear. The present study examined posterior cranial fossa (PCF) morphometrics and a broad range of health instruments of pediatric ICTE cases and matched controls extracted from the Adolescent Brain Cognitive Development (ABCD) dataset.

Methods

One-hundred-six subjects with ICTE and 106 matched controls without ICTE were identified from 11,411 anatomical MRI of healthy screened pediatric subjects from the ABCD project. Subjects were matched by sex, age, body mass index, race, and ethnicity. Twenty-two brain morphometrics and 22 health instruments were compared between the two groups to identify unrecognized CMI symptoms and assess the general health impact of ICTE.

Results

Twelve and 15 measures were significantly different between the ICTE and control groups for females and males, respectively. Notably, for females, the anterior CSF space was significantly smaller (p = 0.00005) for the ICTE group than controls. For males, the clivus bone length was significantly shorter (p = 0.0002) for the ICTE group compared to controls. No significant differences were found among the 22 health instruments between the two groups.

Conclusion

This study demonstrated that pediatric ICTE subjects have similar PCF morphometrics to adult CMI. ICTE alone did not appear to cause any unrecognized CMI symptoms and had no impact on the subjects’ current mental, physical, or behavioral health. Still, given their cranial and brain morphology, these cases may be at risk for adult-onset symptomatic CMI.

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Acknowledgements

Data used in the preparation of this article were obtained from the Adolescent Brain Cognitive Development (ABCD) Study (https://abcdstudy.org), held in the NIMH Data Archive (NDA). This is a multisite, longitudinal study designed to recruit more than 10,000 children age 9-10 and follow them over 10 years into early adulthood. The ABCD Study is supported by the National Institutes of Health and additional federal partners under award numbers U01DA041048, U01DA050989, U01DA051016, U01DA041022, U01DA051018, U01DA051037, U01DA050987, U01DA041174, U01DA041106, U01DA041117, U01DA041028, U01DA041134, U01DA050988, U01DA051039, U01DA041156, U01DA041025, U01DA041120, U01DA051038, U01DA041148, U01DA041093, U01DA041089, U24DA041123, U24DA041147. A full list of supporters is available at https://abcdstudy.org/federal-partners.html. A listing of participating sites and a complete listing of the study investigators can be found at https://abcdstudy.org/consortium_members/. ABCD consortium investigators designed and implemented the study and/or provided data but did not necessarily participate in analysis or writing of this report. This manuscript reflects the views of the authors and may not reflect the opinions or views of the NIH or ABCD consortium investigators.

The ABCD data repository grows and changes over time. The ABCD data used in this report came from the fast track data release. The raw data are available at https://nda.nih.gov/edit_collection.html?id=2573.

Funding

The study was funded by Conquer Chiari.

Author information

Authors and Affiliations

  1. Conquer Chiari Research Center, Department of Mechanical Engineering, The University of Akron, Akron, OH, USA

    Blaise Simplice Talla Nwotchouang, Alaaddin Ibrahimy & Francis Loth

  2. Conquer Chiari Research Center, The University of Akron, Akron, OH, USA

    Dorothy M. Loth, Edward Labuda, Nicholas Labuda & Maggie Eppleheimer

  3. Conquer Chiari, Wexford, PA, USA

    Richard Labuda

  4. Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA

    Jayapalli Rajiv Bapuraj

  5. Conquer Chiari Research Center, Department of Psychology, The University of Akron, Akron, OH, USA

    Philip A. Allen

  6. The Warren Alpert Medical School of Brown University, Providence, RI, USA

    Petra Klinge

Authors
  1. Blaise Simplice Talla Nwotchouang
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  11. Francis Loth
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Corresponding author

Correspondence to Blaise Simplice Talla Nwotchouang.

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Ethical approval

This study was approved by the local institutional review board at The University of Akron. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

Author Jayapalli Rajiv Bapuraj is a recipient of a research grant from Conquer Chiari.

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Nwotchouang, B.S.T., Ibrahimy, A., Loth, D.M. et al. Imaging and health metrics in incidental cerebellar tonsillar ectopia: findings from the Adolescent Brain Cognitive Development Study (ABCD). Neuroradiology 63, 1913–1924 (2021). https://doi.org/10.1007/s00234-021-02759-y

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