# Microstructural Injury to the Brainstem and Spinal Cord Determines Outcomes in CM and SM

> **NIH NIH P01** · WASHINGTON UNIVERSITY · 2024 · $85,312

## Abstract

Project 3: Abstract
Chiari type I malformation (CM), defined for >100 years as cerebellar tonsillar ectopia through the
foramen magnum, encompasses a broad array of radiological and clinical features, with patients
ranging from essentially asymptomatic (i.e. incidental discovery) to suffering disabling
neurological symptoms from cervicomedullary compression. Indeed, this oversimplified and
outdated definition of CM depends solely on a single, static 2D sagittal MRI image, and fails to
consider the complex and dynamic pathophysiology at the interface of CM pathology involving
the cerebellum, brainstem, and spinal cord. The objective of this proposal is to predict long term
outcomes in CM through understanding cerebrospinal fluid (CSF)-mediated microstructural injury.
The Central Hypotheses are that: 1) Novel MRI measures of microstructural injury are associated
with CM disease severity, functional outcome, and therapeutic response and 2) Brain-CSF
circulation is altered in symptomatic CM, is associated with microstructural injury, and responds
to neurosurgical treatment. To test these hypotheses, we will address the following Specific Aims:
Specific Aim 1: Determine whether novel brainstem measures of microstructural injury reflect
neurological impairments and predict long-term outcomes in patients with CM.
Specific Aim 2: Determine CSF circulation in the brainstem, cerebellum and spinal cord
through dynamic 4D CSF flow of the brain-CSF interfaces, their response to surgical treatment,
and relationship to microstructural injury.

## Key facts

- **NIH application ID:** 10876283
- **Project number:** 5P01NS131131-02
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Jennifer Strahle
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $85,312
- **Award type:** 5
- **Project period:** 2023-07-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10876283

## Citation

> US National Institutes of Health, RePORTER application 10876283, Microstructural Injury to the Brainstem and Spinal Cord Determines Outcomes in CM and SM (5P01NS131131-02). Retrieved via AI Analytics 2026-06-23 from https://api.ai-analytics.org/grant/nih/10876283. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*