New ASAP Chiari & Syringomyelia Research


In latest issue of their Connections newsletter, the American Syringomyelia & Chiari Alliance Project (ASAP) announced four new Chiari/syringomyelia research projects:

Chiari Severity Index (CSI)

Pediatric neurosurgeon Dr. David Limbrick from Washington University and St Louis Children’s Hospital will be principle investigator for the study Developing a Preoperative Chiari Severity Index to Stratify Prospective Clinical Studies for Chiari type I Malformation.

Development of a preoperative severity index “is crucial to designing and conducting clinical trials to assess differential efficacy of the various surgical approaches for CMI.” The Chiari Severity Index (CSI) will be “a multi-dimensional composite index that classifies the severity of clinical and radiographic findings for children presenting with CMI.” Following validation of the index, the CSI will serve two critical roles:

  • “Providing meaningful prognostic information to anticipate clinical outcomes in CMI”
  • “Stratifying patients for prospective clinical trials evaluating the differential efficacy of major CMI treatment approaches.”

Posterior Fossa Volumes in Symptomatic vs. Asymptomatic Chiari I in Children

Neurosurgical resident Dr. Alan Siu at George Washington University, Children’s National Medical Center will study the Comparative Analysis of Posterior Fossa Volumes in Symptomatic versus Asymptomatic Chiari I Malformation in Children. The project aims to:

  • “To determine if posterior fossa volumes are significantly different in incidental patients who subsequently develop symptoms compared to asymptomatic patients.”
  • “To determine if differences in posterior fossa volumes exist in patients with and without syringomyelia.”
  • “Determine if postoperative changes in posterior fossa volumes correlate with resolution of symptoms in patients with CMI.”
  • “To determine the effects of duraplasty on clinicoradiographic resolution.”
  • “To correlate the changes in posterior fossa volume with syrinx resolution.”

4D PC MRI CSF Motion in CM and SM

Principal Investigator Bryn Martin, Ph.D. of the Conquer Chiari Research Center at the University of Akron, in Akron, Ohio will evaluate CSF dynamics using a new more sensitive MRI technique in the research trial Multicenter in Vitro Assessment of 4D PC MRI for Quantification of Cerebrospinal Fluid Motion in Chiari Malformation and Syringomyelia.

“This project will help to understand CSF flow near the base of the brain in Chiari that could help identify new treatment possibilities and improve diagnostic capabilities.”

Determining the Clinic-pathological Significance of CSF Flow in CM

Principal Investigator Mark Quigley, Ph.D. of the Children’s National Medical Center will assess the dynamics of CSF flow across the foramen magnum in the study Is CSF Flow the “Holy Grail” to Determining Clinic-pathological Significance of Chiari Malformation?

Dr. Quigley will use an analytical technique he developed called Spatial-Temporal Mapping to:

  • “Determine if abnormal CSF flow is a good diagnostic for non-Chiari syringomyelia”
  • “Determine if CSF flow might be used to distinguish between tethered and non-tethered cord Chiari/ syringomyelia patients”