A case-control study on the driving factors of childhood brain volume loss: What pediatricians must explore

Richard Sungura1, Gabriel Shirima1, John Spitsbergen2

  • 1Department of Health and Biomedical Sciences, School of Life Science, Nelson Mandela- African Institution of Science and Technology, Arusha, Tanzania.

Plos One
|December 30, 2022
PubMed

Insights

Childhood brain atrophy is linked to factors like male gender, head trauma, and birth complications. Space-occupying lesions and intracranial pressure are key drivers of this condition in pediatric patients.

Area of Science:

  • Pediatric Neurology
  • Neuroimaging
  • Child Development

Background:

  • Brain volume loss (brain atrophy) is increasingly detected in children via CT and MRI scans.
  • Severe brain atrophy can cause neurocognitive deficits affecting processing speed, reasoning, and memory, altering personality.
  • Understanding factors causing pre-senile brain atrophy in children is crucial.

Purpose of the Study:

  • To explore factors contributing to childhood brain atrophy.
  • To utilize quantitative brain CT scan evaluation to identify these factors.

Main Methods:

  • A case-control study comparing 168 children with brain atrophy to 168 age- and gender-matched controls.
  • All subjects were under 18 years old and underwent brain CT scans.
  • Detailed review of birth and medical history, including laboratory reports, was conducted.

Main Results:

  • Significant risk factors identified include: male gender (OR=1.9), age 14-17 (OR=1.1), immaturity (OR=1.04), head trauma (OR=1.02), radiation injury (OR=1.06), and birth injury/asphyxia (OR=1.02).
  • Factors like malnutrition (OR=0.97) and birth outside facility (OR=0.99) showed inverse trends.
  • Maternal alcoholism and antiepileptic drugs/convulsive disorders had an OR of 1.0.

Conclusions:

  • Pathological brain volume reduction in children shows a trend with increasing pediatric age.
  • Space-occupying lesions and increased intracranial pressure are the most significant causes of childhood brain atrophy.
Abstract