STRUCTURAL CHANGES IN BRAIN ON CRANIAL MAGNETIC RESONANCE IMAGING (MRI) IN SEVERELY MALNOURISHED CHILDREN

Introduction: Malnutrition is a global health problem and nutrition plays a critical role in brain development. The brain of the child is one of the the most vulnerable organs affected during growth with potential morphological changes, which can be detectable with neuroimaging technology.

Objective: To study the structural changes in brain on cranial MRI in Severely Malnourished Children

Design: Prospective Cross-sectional study

Participants: 52 Severely Malnourished (SAM) Children in age group of 0-5 years. The cases with neurological disease like epilepsy, cerebral palsy, meningitis, tumours, hydrocephalus, perinatal asphyxia, or any sign and symptom suggestive of CNS involvement were excluded to detect CNS changes attributable to malnutrition only.

Methods: MRI Brain without contrast was done in all 52 cases and reported by experienced radiologist. Significant MRI findings included cerebral atrophy, dilated ventricles, periventricular white matter changes, widened cortical sulci, enlarged basal cisterns, widened interhemispheric fissure and cerebellar folia. Development assessment using DDST II was also performed to infer correlation with MRI findings.

Results: Out of 52 SAM children, 10 cases (i.e. 19.2%) had abnormal MRI findings. Development assessment revealed that out of 10 abnormal MRI cases 80% had delayed developmental milestones as well, whereas in normal MRI group only 42.8% had delayed development.

Conclusions: Our study reveals that malnutrition per se has a significant effect on structure of the developing brain and also affects the neurological development.