Radiographic patterns of neurosarcoidosis in African-Americans

Neurosarcoidosis is a devastating neurological illness that is potentially reversible if recognized early and treated appropriately. However, recognition is challenging due to the diverse manifestations and lack of specific diagnostic tests. Furthermore, the majority of neurosarcoidosis studies are predominantly focused on Caucasian populations whereas the incidence is higher in African-Americans. Systemic sarcoidosis impacts African-Americans more severely than Caucasians, but the impact of race remains unexplored in neurosarcoidosis. Our study examines the presenting imaging characteristics of neurosarcoidosis in an African-American cohort. We aimed to identify patterns of radiographic involvement, and compare this with knowledge from the existing literature.

Adult patients with neurosarcoidosis who received care at one institution in the Southeastern United States were identified through retrospective chart review. We obtained patients' demographics, and reviewed their presenting neuroimaging, organizing location of radiographic involvement into several categories.

African-American patients with neurosarcoidosis commonly presented with either isolated meningeal enhancement or multiple areas of involvement on their initial brain MRI. While systemic involvement was observed in the majority of cases, most patients were asymptomatic in areas outside the nervous system.

This single institution study describes the radiographic localization of neurosarcoidosis in a large African-American cohort. Many features are similar to what has been described in the literature. Future studies should compare clinical presentations, biomarkers, and cerebrospinal fluid studies amongst varying racial and ethnic groups.