Please wait a minute...
Journal of Integrative Neuroscience  2018, Vol. 17 Issue (4): 343-348    DOI: 10.31083/j.jin.2018.04.0414
Research article Previous articles | Next articles
Anxiety and depression in Chiari malformation
Esther Lázaro1, *(), Maitane Garca1, Imanol Amayra1, Juan-Francisco López-Paz1, Oscar Martnez1, Manuel Pérez1, Sarah Berrocoso1, Mohammad Al Rashaida1, Paula Fernández1, Alicia Rodrguez1, Amaia Jometón1, Begoña Ruz2
1 Avda. Universidades 24, 48007 Bilbao University of Deusto, Spain
2 Spanish Center of Reference for Rare Diseases Calle Bernardino Obregón, 24, 09001 Burgos, Spain
Download:  PDF(171KB)  ( 576 ) Full text   ( 40 )
Export:  BibTeX | EndNote (RIS)      
Abstract  

There are few studies that explore the involvement of the cerebellum in the affective area. This study aims to evaluate the affective component and, specifically, the emotional states of depression and anxiety associated with the Chiari malformation, controlling perceived pain. This study included a Chiari group and two control groups, one healthy, the other suffering from Myasthenia gravis, which exhibits a physical component without cerebellar impairment. Each participant completed the Hospital Anxiety and Depression Scale and the Numeric Pain Rating Scale. Scores were significantly higher for the anxiety variable in the Chiari group, either when compared to the control group or the group affected by Myasthenia gravis-controlling the level of headache. The results obtained support previous studies in which the important contribution of the cerebellum to emotional regulation was emphasized.

Key words:  cerebellum      Chiari malformation      depression      anxiety      pain      observational descriptive study.     
Submitted:  15 May 2017      Accepted:  14 December 2017      Published:  15 November 2018     
*Corresponding Author(s):  Esther Lázaro     E-mail:  estherlazaro@deusto.es

Cite this article: 

Esther Lázaro, Maitane Garca, Imanol Amayra, Juan-Francisco López-Paz, Oscar Martnez, Manuel Pérez, Sarah Berrocoso, Mohammad Al Rashaida, Paula Fernández, Alicia Rodrguez, Amaia Jometón, Begoña Ruz. Anxiety and depression in Chiari malformation. Journal of Integrative Neuroscience, 2018, 17(4): 343-348.

URL: 

https://jin.imrpress.com/EN/10.31083/j.jin.2018.04.0414     OR     https://jin.imrpress.com/EN/Y2018/V17/I4/343

Table 1  The scores on depression and anxiety between the two evaluated diseases
n Mean Standard deviation
HAD Anxiety Control 20 4.60 4.03
Chiari 19 12.11 5.31
Myasthenia 31 7.90 4.25
HAD Depression Control 20 1.70 1.94
Chiari 19 8.05 4.32
Myasthenia 31 5.81 4.04
HAD Total Control 20 6.250 5.72
Chiari 19 20.158 8.93
Myasthenia 31 13.935 7.26
[1] Babinski J ( 1899) De l’asynergie cérébelleuse. Revue Neurologique 7, 806-816.
[2] Pollack IF, Polinko P, Albright AL, Towbin R, Fitz C ( 1995) Mutism and pseudobulbar symptoms after resection of posterior fossa tumors in children: Incidence and pathophysiology. Neurosurgery 37(5), 885-93.
[3] Grafman J, Litvan I, Massaquoi S, Stewart M, Sirigu A, Hallett M ( 1992) Cognitive planning deficit in patients with cerebellar atrophy. Neurology 42(8), 1493-1493.
doi: 10.1212/WNL.42.8.1493 pmid: 1641142
[4] Wallesch CW, Horn A ( 1990) Long-term effects of cerebellar pathology on cognitive functions. Brain and Cognition 14(1), 19-25.
[5] Schmahmann JD, Sherman JC ( 1998) The cerebellar cognitive affective syndrome. Brain 12(4), 561-579.
doi: 10.5546/aap.2015.e268
[6] Richter S, Dimitrova A, Maschke M, Gizewski E, Beck A, Aurich V , Timmann D. ( 2005) Degree of cerebellar ataxia correlates with three-dimensional MRI-based cerebellar volume in pure cerebellar degeneration. European Neurology 54( 1), 23-27.
doi: 10.1159/000087241 pmid: 16088175
[7] Richter S, Gerwig M, Aslan B, Wilhelm H, Schoch B, Dimitrova A, Gizewski E, Ziegler W, Karnath H, Timmann D ( 2007) Cognitive functions in patients with MR-defined chronic focal cerebellar lesions. Journal of Neurology 254(9), 1193-1203.
doi: 10.1007/s00415-006-0500-9 pmid: 17380238
[8] Schmahmann JD, Weilburg JB, Sherman JC ( 2007) The neuropsychiatry of the cerebellum—insights from the clinic. The Cerebellum 6(3), 254-267.
[9] Hoffmann M, Cases LB ( 2008) Etiology of frontal network syndromes in isolated subtentorial stroke. Behavioural Neurology 20(3-4), 101-105.
doi: 10.3233/BEN-2008-0220 pmid: 5452455
[10] Paulus KS, Magnano I, Conti M, Galistu P, D’Onofrio M, Satta W, Aiello I ( 2004) Pure post-stroke cerebellar cognitive affective syndrome: a case report. Neurological Sciences 25( 4), 220-224.
doi: 10.1007/s10072-004-0325-1 pmid: 15549508
[11] Jawaid A, Rauf MA, Usman U, Khealani BA ( 2008) Post-infarct cerebellar cognitive affective syndrome: a case report. Journal of the Pakistan Medical Association 58(7), 415.
pmid: 18988420
[12] Turner BM, Paradiso S, Marvel CL, Pierson R, Ponto LLB, Hichwa RD, Robinson RG ( 2007) The cerebellum and emotional experience. Neuropsychologia 45(6), 1331-1341.
doi: 10.1016/j.neuropsychologia.2006.09.023
[13] Lang PJ, Bradley MM, Cuthbert BN ( 1997) Motivated attention: Affect, activation, and action. Attention and orienting: Sensory and Motivational Processes 97, 135.
[14] Wolf U, Rapoport MJ, Schweizer TA ( 2009) Evaluating the affective component of the cerebellar cognitive affective syndrome. Journal of Neuropsychiatry Clinical Neuroscience 21(3), 245-253.
[15] Braga-Neto P, Pedroso JL, Alessi H, Dutra LA, Felcio AC, Minett T, Weisman P, Santos-Galduroz RF, Bertolucci P, Gabbai A, Barsottini OGP ( 2012) Cerebellar cognitive affective syndrome in Machado Joseph disease: core clinical features. The Cerebellum 11(2), 549-556.
doi: 10.1007/s12311-011-0318-6 pmid: 21975858
[16] Gambardella A, Annesi G, Bono F, Spadafora P, Valentino P, Pasqua AE, Mazzei R, Montesanti R, Conforti FL, Oliveri RL, Zappia M, Aguglia U, Quattrone A ( 1998) CAG repeat length and clinical features in three Italian families with spinocerebellar ataxia type 2 (SCA2): early impairment of Wisconsin Card Sorting Test and saccade velocity. Journal of Neurology 245(10), 647-652.
doi: 10.1007/s004150050261 pmid: 9776463
[17] Storey E, Forrest SM, Shaw JH, Mitchell P, Gardner RM ( 1999) Spinocerebellar ataxia type 2: clinical features of a pedigree displaying prominent frontal-executive dysfunction. Archives of Neurology 56(1), 43-50.
doi: 10.1001/archneur.56.1.43 pmid: 9923760
[18] Nieto A, Correia R, Nóbrega E, Montón F, Hess S, Barroso J ( 2012) Cognition in Friederich ataxia. Cerebellum 11, 834-844.
[19] Mestres O, Poca MA, Solana E, Rodoi A, Quintana M, Force Sanmartn E, Sahuquillo J ( 2012) Evaluación de la calidad de vida en los pacientes con una malformación de Chiari tipo I. Estudio piloto en una cohorte de 67 pacientes. Revista de Neurologa 55(3), 148-156.
[20] Bejjani GK ( 2001) Definition of the adult Chiari malformation: a brief historical overview. Neurosurgical Focus 11(1), 1-8.
doi: 10.3171/foc.2001.11.1.2 pmid: 16724811
[21] Caykoylu A, Ekinci O, Albayrak Y, Kuloglu M, Deniz O ( 2008) Arnold - Chiari I malformation association with generalized anxiety disorder: a case report. Progress in Neuro-psychopharmacology & Biological Psychiatry 32(6), 1613-1614.
[22] Klein R, Hopewell CA, Oien M ( 2014) Chiari Malformation Type I: A neuropsychological case study. Military Medicine 179(6), e712-e718.
doi: 10.7205/MILMED-D-13-00227 pmid: 24902143
[23] Allen PA, Houston JR, Pollock JW, Buzzelli C, Li X, Harrington AK, Bryn AM, Francis Loth M, Jahangir J, Luciano MG ( 2014) Task-specific and general cognitive effects in Chiari malformation type I. PLOS One 9(4), e94844.
doi: 10.1371/journal.pone.0094844 pmid: 24736676
[24] Koziol L, Budding D, Andreasen N, D’Arrigo S, Bulgheroni S, Imamizu H, Ito Manto M, Marvel C, Parker K, Pezzulo G, Ramnani N, Riva D, Schmahmann J, Vandervert L, Yamazak T ( 2014) Consensus Paper: The cerebellum’s role in movement and cognition. The Cerebellum 13(1), 151-177.
[25] Beck A, Steer R, Brown G ( 1961). Inventario de depresión de Beck. Archives of General Psychiatry 4, 561-571.
[26] Pascual J, Iglesias F, Oterino A, Vazquez-Barquero A, Berciano J ( 1996) Cough, exertional, and sexual headaches: an analysis of 72 benign and symptomatic cases. Neurology 46(6), 1520-1524.
doi: 10.1212/WNL.46.6.1520 pmid: 8649540
[27] Nohria V, Oakes W ( 1993) Chiari headaches. Neurology 43(6), 1272.
[28] Stovner LJ ( 1993). Headache associated with Chiari type I malformation. Headache 33, 175-181.
doi: 10.1111/j.1526-4610.1993.hed33040175.x pmid: 8496055
[29] Milhorat TH, Chou MW, Trinidad EM , et al. ( 1999) Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery 44(5), 1005-1017.
doi: 10.1097/00006123-199912000-00054 pmid: 10232534
[30] Koenig TW, Clark M ( 1996) Advances in comprehensive pain management. Psychiatric Clinical North America 19(3), 589-611.
doi: 10.1016/S0193-953X(05)70307-5 pmid: 8856818
[31] Argoff C ( 2007) The Coexistence of Neuropathic Pain, Sleep, and Psychiatric Disorders. Clinical Journal of Pain 23(23), 15-22.
[32] Annagür B, Uguz F, Apiliogullari S, Kara I, Gunduz S ( 2014) Psychiatric disorders and association with quality of sleep and quality of life in patients with chronic pain: a SCID based study. Pain Medicine 15(5), 772-81.
doi: 10.1111/pme.12390 pmid: 24612225
[33] Demir AB, Kotan Z, Kotan VO, Bora I ̇ , Zkaya G ( 2016) Pain, Daytime Sleepiness, Anxiety and Depression Neuropathic Pain syndromes. Journal of Neurological Sciences 33(1), 89-101.
[34] Kuks J, Oosterhuis H ( 2003) Clinical presentation and epidemiology of myasthenia gravis. In H Kaminski (Ed.), Current Clinical Neurology: Myasthenia Gravis and Related Disorders (pp. 93-113). Totowa, NJ: Human Press.
[35] Bartel P, Lotz B ( 1995) Neuropsychological test performance and affect in myasthenia gravis. Acta Neurologica Scandinavica 91(4), 266-270.
doi: 10.1111/j.1600-0404.1995.tb07002.x pmid: 7625152
[36] Ybarra M, Kummer A, Comini E, Oliveira J, Gómez R, Texeira A ( 2011) Psychiatric disorders in myasthenia gravis. Arquivos de Neuro-Psiquiatra 69, 176-179.
doi: 10.1590/S0004-282X2011000200006 pmid: 21537555
[37] Keesey J ( 1999) Does myasthenia gravis affect the brain? Journal of Neurological Science 170(2), 77-89.
doi: 10.1016/S0022-510X(99)00205-1 pmid: 10561522
[38] Zigmond AS, Snaith RP ( 1983) The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica 67(6), 361-370.
[39] Tyrer P, Methuen C ( 2007) Rating Scales in Psychiatry. London: RCPSYCH Publications.
[40] Brennan C, Worrall-Davies A, McMillan D, Gilbody S, House A ( 2010) The Hospital Anxiety and Depression Scale: a diagnostic meta-analysis of case-finding ability. Journal of Psychosomatic Research 69(4), 371-378.
doi: 10.1016/j.jpsychores.2010.04.006 pmid: 20846538
[41] Terol M C, López-Roig S, Rodriguez Marn J, Martn Aragón M, Pastor M A, Reig M T ( 2007) Propiedades psicométricas de la escala Hospitalaria de Ansiedad y Depresión (HAD) en población Española. Ansiedad y Estrés 13(2-3), 163-176.
[42] Hawker G ( 2011) Measures of Adult Pain. Arthritis Care & Research 63(S11), S240-S252.
[43] Ferraz M, Quaresma M, Aquino L, Atra E, Tugwell P, Goldsmith CH ( 1990) Reliability of pain scales in the assessment of literate and illiterate patients with rheumatoid arthritis. Journal of Rheumatology 17(8), 1022-1024.
pmid: 2213777
[44] Leroi I, O’Hearn E, Marsh L, Lyketsos C, Rosenblatt A, Christopher R, Brandt J, Margolis R ( 2002) Psychopathology in patients with degenerative cerebellar diseases: a comparison to Huntington’s disease. American Journal of Psychiatry 159(8), 1306-1314
doi: 10.1176/appi.ajp.159.8.1306 pmid: 12153822
[45] Caulfield MD, Servatiu RJ ( 2013) Focusing on the possible role of the cerebellum in anxiety disorders. New Insights Into Anxiety Disorders (Durbano F, Ed). InTech, Rijeka, HR, 41-70.
[46] Bakim B, Goksan Yavuz A, Yilmaz A, Karamustafalioglu O, Akbiyik M, Yayla S, Yuce I, Alpak G, Tankaya O ( 2013) The quality of life and psychiatric morbidity in patients operated for Arnold-Chiari malformation type I. International Journal of Psychiatry in Clinical Practice 17(4), 259-263.
doi: 10.3109/13651501.2013.778295 pmid: 23437799
[47] Schmahmann JD ( 2013) Cerebellar cognitive affective syndrome and the neuropsychiatry of the cerebellum. In Handbook of the Cerebellum and Cerebellar Disorders ( pp. 1717-1751). Springer Netherlands.
doi: 10.1007/978-94-007-1333-8_77
[48] Ferrucci R, Priori A ( 2014) Transcranial cerebellar direct current stimulation (tcDCS): motor control, cognition, learning and emotions. Neuroimage 85(2), 918-923.
doi: 10.1016/j.neuroimage.2013.04.122 pmid: 23664951
[1] Jie Chen, Yunling Huang, Ling Li, Jie Niu, Weiqiong Ye, Yunnan Wang, Can Yan, Lili Wu. Antidepressant pathways of the Chinese herb jiaweisinisan through genetic ontology analysis[J]. Journal of Integrative Neuroscience, 2020, 19(2): 385-395.
[2] Ran Ye, Miao Zhang, Song Zhang, Shasha Bai, Zhangyu Jiang, Qiang Cai, Kerun Cao, Chongkun Shen, Yafei Shi, Rong Zhang, Lei Yang. Stress causes cognitive impairment by affecting cholesterol efflux and reuptake leading to abnormalities in lipid metabolism of rats[J]. Journal of Integrative Neuroscience, 2020, 19(1): 39-49.
[3] Jiajia Wu, Shuai Wang, Yechen Lu, Mouxiong Zheng, Xuyun Hua, Jianguang Xu. Shifted hub regions in the brain network of rat neuropathic pain model after electroacupuncture therapy[J]. Journal of Integrative Neuroscience, 2020, 19(1): 65-75.
[4] Shuo Jiang, Quan-ai Zhang, Qin Guo, Zhong Di. The glutamatergic system and astrocytic impairment in rat hippocampus: a comparative study of underlying etiology and pathophysiology of depression[J]. Journal of Integrative Neuroscience, 2019, 18(4): 387-392.
[5] Shun Wang, Shanping Mao, Baozhen Yao, Dan Xiang, Congcong Fang. Effects of low-frequency repetitive transcranial magnetic stimulation on depression- and anxiety-like behaviors in epileptic rats[J]. Journal of Integrative Neuroscience, 2019, 18(3): 237-243.
[6] Evgeniy A. Cheremushkin, Nadezda E. Petrenko, Irina A. Yakovenko, Sergei A. Gordeev, Nikolay N. Alipov, Olga V. Sergeeva. Human neurophysiological markers of high anxiety level during preparation for visual recognition[J]. Journal of Integrative Neuroscience, 2018, 17(3): 193-202.
[7] J. Meléndez-Gallardo, A. Eblen-Zajjur. Thermo-dependence of noxious mechanical heterotopic stimulation-dependent modulation of the spinal dorsal horn response to somatosensory stimulation[J]. Journal of Integrative Neuroscience, 2018, 17(3): 249-256.
[8] Xinqiang Ni, Yingzhao Liao, Limin Li, Xiaoli Zhang, Zhengzhi Wu. Therapeutic role of long non-coding RNA TCONS_00019174 in depressive disorders is dependent on Wnt/$\beta$-catenin signaling pathway[J]. Journal of Integrative Neuroscience, 2018, 17(2): 125-132.
[9] Hong Peng, Hong-bin Wang, Ling Wang, Bing Zhou, Xiao-yong Li, Jian Tan. Gsk-3$ \beta $ aggravates depression symptoms in a chronic stress mouse model[J]. Journal of Integrative Neuroscience, 2018, 17(2): 169-176.
[10] Zahra Khayyer, Leonard Ngaosuvan, Sverker Sikström, Amir Hossein Ghaderi. Transcranial direct current stimulation based on qEEG combining positive psychotherapy for major depression[J]. Journal of Integrative Neuroscience, 2018, 17(2): 89-96.
No Suggested Reading articles found!