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Brain imaging in normal kids: a community-based MRI study in Malawian children
M J Potchen1, S D Kampondeni, M Mallewa
1Department of Radiology, Michigan State University, East Lansing, MI, USA.
Insights
Incidental brain MRI abnormalities are common in Malawian children, with findings like atrophy and white matter changes potentially linked to Malawi-specific exposures. These abnormalities were not associated with common risk factors in this pediatric population.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Radiology
Background:
- Collecting normative neuroimaging data is crucial for clinical diagnosis and research.
- Understanding common neurological insults in pediatric populations requires population-specific data.
- Previous studies have focused on Western populations, potentially missing region-specific findings.
Purpose of the Study:
- To gather normative brain Magnetic Resonance Imaging (MRI) data in a community-based sample of Malawian children.
- To identify the prevalence and types of incidental brain MRI abnormalities in healthy children.
- To explore potential risk factors associated with these MRI findings.
Main Methods:
- A representative sample of 102 children aged 9-14 years from Malawi was screened.
- Eligible children underwent a neurological examination and brain MRI.
- Demographic, medical history, and environmental exposure data were collected.
Main Results:
- Of 96 enrolled children, 23% had brain abnormalities, including white matter changes and atrophy.
- Sinusitis was the most common MRI finding (30%).
- No significant associations were found between MRI abnormalities and demographic or clinical factors.
Conclusions:
- Incidental brain MRI abnormalities are prevalent in healthy Malawian children.
- Observed abnormalities, such as atrophy and white matter changes, differ from those typically seen in US populations.
- Malawi-specific environmental or genetic exposures may contribute to these unique findings.
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.
