Brain imaging in normal kids: a community‐based MRI study in Malawian children

• Published in: Tropical medicine & international health 2013-04, Vol.18 (4), p.398-402
• Main Authors: Potchen, M. J., Kampondeni, S. D., Mallewa, M., Taylor, T. E., Birbeck, G. L.
• Format: Article
• Language: English
• Subjects: abnormal brain MRI; Adolescent; Biological and medical sciences; Brain; Brain - pathology; Brain Diseases - diagnosis; Child; Children & youth; developmental delay; Female; General aspects; Humans; Magnetic Resonance Imaging - methods; Malawi; Male; Medical sciences; Medical screening; Nervous System Diseases - diagnosis; Neuroimaging - methods; Neurological disorders; NMR; Non tumoral diseases; Nuclear magnetic resonance; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Predictive Value of Tests; Risk Factors; sinusitis; Sinusitis - diagnosis
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/tmi.12064

Objective To collect normative MRI data for effective clinical and research applications. Such data may also offer insights into common neurological insults. Methods We identified a representative, community‐based sample of children aged 9–14 years. Children were screened for neurodevelopmental problems. Demographic data, medical history and environmental exposures were ascertained. Eligible children underwent the Neurologic Examination for Subtle Signs (NESS) and a brain MRI. Descriptive findings and analyses to identify risk factors for MRI abnormalities are detailed. Results One hundred and two of 170 households screened had age‐appropriate children. Two of 102 children had neurological problems – one each with cerebral palsy and epilepsy. Ninety‐six of 100 eligible children were enrolled. Mean age was 11.9 years (SD 1.5), and 43 (45%) were boys. No acute MRI abnormalities were seen. NESS abnormalities were identified in 6 of 96 children (6%). Radiographic evidence of sinusitis in 29 children (30%) was the most common MRI finding. Brain abnormalities were found in 16 (23%): mild diffuse atrophy in 4 (4%), periventricular white matter changes/gliosis in 6 (6%), multifocal punctuate subcortical white matter changes in 2 (2%), vermian atrophy in 1 (1%), empty sella in 3 (3%) and multifocal granulomas with surrounding gliosis in 1 (1%). Having an abnormal MRI was not associated with age, sex, antenatal problems, early malnutrition, febrile seizures, an abnormal neurological examination or housing quality (all P values >0.05). No predictors of radiographic sinusitis were identified. Conclusion Incidental brain MRI abnormalities are common in normal Malawian children. The incidental atrophy and white matter abnormalities seen in this African population have not been reported among incidental findings from US populations, suggesting Malawi‐specific exposures may be the cause. Objectif Recueillir des données IRM normatives pour des applications cliniques et de recherche efficaces. De telles données peuvent également offrir un aperçu sur les affections neurologiques courantes. Méthodes Nous avons identifié un échantillon représentatif, basé sur la communauté d'enfants âgés de 9 à 14 ans. Les enfants ont été examinés pour des problèmes de développement neurologique. Les données démographiques, les antécédents médicaux et les expositions environnementales ont été constatés. Les enfants éligibles ont subi l'examen neurologique pour les signes subtils (ENSS) et une