García Maitane, Amayra Imanol, Pérez Manuel, Rodríguez Alicia Aurora, Salgueiro Monika, Infante Jon
Neuro-e-Motion Research Team, Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain.
Faculty of Health Sciences, Isabel I University, Burgos, Spain.
Intractable Rare Dis Res. 2024 Aug 31;13(3):148-156. doi: 10.5582/irdr.2024.01010.
Chiari Malformation type I (CM-I) is a neurological disorder characterized by cerebellar tonsillar herniation. Chronic pain, particularly headaches, is a prevalent symptom in CM-I patients, significantly impacting their quality of life. The objective of this study was to evaluate the perceived quality of life in adults with CM-I and examine the influence of chronic pain and comorbid symptoms on their well-being. 26 CM-I patients (8 with decompressive surgery) and 26 matched healthy controls were recruited. Participants completed the following questionnaires: WHOQOL-BREF, HDI, NDI, OLBPDQ and HADS. CM-I patients exhibited significantly lower scores across all domains of quality of life when compared to healthy controls. Chronic pain, including headache, neck pain, and low back pain, was more pronounced among CM-I patients and demonstrated a significant correlation with depressive symptoms. Notably, after controlling for chronic pain, the differences in quality of life between CM-I patients and controls diminished. The results suggest that chronic pain, especially headaches, and comorbid depressive symptoms exert a substantial impact on the quality of life of CM-I patients. Surgical intervention alone may not fully address these issues, highlighting the importance of considering psychological interventions as part of the comprehensive treatment. Further research with larger samples and pre-post-surgery assessments is needed to validate these findings and explore the potential benefits of psychological therapies in enhancing the quality of life for CM-I patients.
I型Chiari畸形（CM-I）是一种以小脑扁桃体疝为特征的神经系统疾病。慢性疼痛，尤其是头痛，是CM-I患者的常见症状，严重影响他们的生活质量。本研究的目的是评估成年CM-I患者的生活质量感知，并研究慢性疼痛和共病症状对其幸福感的影响。招募了26名CM-I患者（8名接受减压手术）和26名匹配的健康对照。参与者完成了以下问卷：世界卫生组织生活质量简表（WHOQOL-BREF）、头痛残疾指数（HDI）、神经功能缺损指数（NDI）、枕下和耳后疼痛障碍问卷（OLBPDQ）和医院焦虑抑郁量表（HADS）。与健康对照相比，CM-I患者在生活质量的所有领域得分均显著较低。慢性疼痛，包括头痛、颈部疼痛和下背部疼痛，在CM-I患者中更为明显，并且与抑郁症状显著相关。值得注意的是，在控制慢性疼痛后，CM-I患者与对照之间的生活质量差异减小。结果表明，慢性疼痛，尤其是头痛，以及共病的抑郁症状对CM-I患者的生活质量有重大影响。仅手术干预可能无法完全解决这些问题，这突出了将心理干预作为综合治疗一部分的重要性。需要进行更大样本和手术前后评估的进一步研究，以验证这些发现，并探索心理治疗在提高CM-I患者生活质量方面的潜在益处。
