Year In Research: 2008, The Song Remains The Same

 Unfortunately, when it comes to Chiari research, in large part the song remains the same. In 2008, there were 149 English language publications on Chiari and/or syringomyelia (Figure 1). Although this is a slight decrease from the previous year, when studies where CM/SM were not the primary focus and case studies which involve only a couple of patients are removed, the adjusted total (78) (Figure 2) actually represents a slight increase over 2007. This means that even though the total quantity of research dipped, the number of quality studies increased slightly. However, both numbers remain ridiculously low as compared to diseases such as multiple sclerosis.

Table 1
2008 PubMed CM/SM Citations By Subject Type (149 Total)

Subject # of Citations
Total 149
Incidental Reference 13
Case Study 58
Outcomes 14
Surgical Technique 8
Theories 3
Imaging/Diagnosis 7
Symptoms 11
Related Conditions 2
Chiari II/Spina Bifida 12
Animal 9
Morphological 2
Reviews 2
Scoliosis 2
PTS 3
Acquired 2

Notes:

  • Incidental refers to a study which mentions Chiari or syringomyelia in passing, but CM/SM is not the focus of the publication

  • Case studies refer to publications which report on 3 or fewer patients and are mostly descriptive in nature

Table 2
Yearly CM/SM Research Citations (2004-2008)

'08 '07 '06 '05 '04
Total English Language Citations 149 161 131 137 122
Adjusted Total 78 72 52 39 53

Note: Adjusted Total refers to the Total Number of Citations minus the Incidental and Case Study citations


Interestingly, among the limited pool of Chiari research, outcome studies, symptoms, and imaging studies represented more than 40% of the work. In addition, there were the usual publications on animals, skull dimensions (morphology), and spina bifida.
Some of the highlights from the 2008 research include:

  • A continued, although controversial, focus on the potential relationship between Tethered Cord Syndrome and Chiari

  • Strong scientific data that a subset of Chiari patients also have connective tissue issues which can affect their treatment needs

  • Studies linking migraines, childhood hearing loss, and restless leg syndrome to Chiari

  • A detailed look at the risks which Chiari surgery can pose in terms of cervical instability and the treatment required to stabilize it

  • In a positive move, some outcome studies have begun to track symptom recurrence over time; which unfortunately showed that symptoms due tend to come back for some people

Not to pat ourselves on the back too hard, but perhaps the most significant event in Chiari research in 2008 was the NIH sponsored Conquer Chiari Research Conference. The event was extremely well attended and generated tremendous discussion. In addition, it brought Chiari into the awareness of NIH, which hopefully will result in more funding.

One of the highlights of the conference was a presentation by Dr. Milhorat, in which he suggested that Chiari patients could be categorized by the the underlying cause of the Chiari: small posterior fossa, tethered cord, connective tissue issues, CSF issues, etc. Conquer Chiari has spoken out in favor of such an approach in the past and wholeheartedly supports this type of progress.

Working groups at the conference generated ideas ranging from a patient registry to a large genetic study to a newsletter for general neurosurgeons about Chiari.

Although the progress often seems slow, and the answers can not come soon enough, progress is being made and there is a growing hope that one day we will Conquer Chiari.

Related C&S News Articles:

The Year In Research, 2007

The Year In Research 2006, Same As It Ever Was

The Year In Research - 2005

The Year In Research