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Brain imaging in normal kids: a community‐based MRI study in M alawian children
Author(s) -
Potchen M. J.,
Kampondeni S. D.,
Mallewa M.,
Taylor T. E.,
Birbeck G. L.
Publication year - 2013
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12064
Subject(s) - medicine , atrophy , gliosis , pediatrics , cerebral palsy , magnetic resonance imaging , epilepsy , white matter , pathology , radiology , physical therapy , psychiatry
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 N eurologic E xamination for S ubtle S igns ( 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 M alawian children. The incidental atrophy and white matter abnormalities seen in this A frican population have not been reported among incidental findings from US populations, suggesting M alawi‐specific exposures may be the cause.