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Chiari 1000 Registry Project: assessment of surgical outcome on self-focused attention, pain, and delayed recall

Published online by Cambridge University Press:  19 October 2017

P. A. Allen ,
D. Delahanty ,
K. P. Kaut ,
X. Li ,
M. Garcia ,
J. R. Houston ,
D. M. Tokar ,
F. Loth ,
J. Maleki  and
S. Vorster
...Show all authors
P. A. Allen*
Affiliation:
Department of Psychology, University of Akron, Akron, OH, USA
D. Delahanty
Affiliation:
Department of Psychological Sciences, Kent State University, Kent, OH, USA
K. P. Kaut
Affiliation:
Department of Psychology, University of Akron, Akron, OH, USA
X. Li
Affiliation:
Department of Psychology, University of Akron, Akron, OH, USA
M. Garcia
Affiliation:
Department of Psychological Sciences, Kent State University, Kent, OH, USA
J. R. Houston
Affiliation:
Department of Psychology, University of Akron, Akron, OH, USA
D. M. Tokar
Affiliation:
Department of Psychology, University of Akron, Akron, OH, USA
F. Loth
Affiliation:
Department of Mechanical Engineering, University of Akron, Akron, OH, USA
J. Maleki
Affiliation:
Department of Neurology, Cleveland Clinic Foundation, Cleveland, OH, USA
S. Vorster
Affiliation:
Department of Neurological Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
M. G. Luciano
Affiliation:
Department of Neurosurgery, Johns Hopkins Medical Center, USA
*
Author for correspondence: P. A. Allen, E-mail: paallen@uakron.edu
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Abstract

Background

Prior research has typically found a negative relationship between chronic pain and memory, and we examined whether cognitive control processes (e.g. reflection and rumination) moderated this relationship in individuals with Chiari malformation Type I (CM). CM is a neurological condition in which the cerebellar tonsils descend into the medullary and upper cervical spine regions potentially resulting in severe headaches and neck pain.

Methods

CM patients who had (n = 341) and had not (n = 297) undergone decompression surgery completed the McGill Pain Questionnaire-Short Form-Revised (SF-MPQ-2), the Rey Auditory Verbal Learning Test (RAVLT), and the Rumination-Reflection Questionnaire (RRQ). Immediate recall scores were compared to those of 102 healthy controls, and delayed recall performance was compared across other variables within the CM group.

Results

CM patients performed more poorly on immediate recall than did controls. Within CM patients, we observed main effects for reflection and age, and a pain x reflection x surgical status (surgery v. no surgery) interaction in which non-decompressed individuals with low levels of pain and high levels of reflection showed superior delayed recall relative to non-decompressed individuals with higher pain and all decompressed individuals.

Conclusions

CM patients show an immediate recall deficit relative to controls, regardless of surgical status. High levels of reflection were associated with better delayed recall performance in non-decompressed CM patients with lower pain levels. High levels of chronic pain may overwhelm increased focused attention abilities, but higher levels of reflection partially overcome the distracting effects of pain and this may represent a type of resilience.

Keywords

Chiari malformationchronic painepisodic memoryreflection and ruminationsuppressor effect
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 10 , July 2018 , pp. 1634 - 1643
Copyright
Copyright © Cambridge University Press 2017 

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