ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Brain Magnetic Resonance Imaging Reveals Different Courses of Disease in Pediatric and Adult Cerebral Malaria.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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41 citing papers in PubMed, 72 citations in OpenAlex.
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- Methylene blue treatment of fatal cerebral malaria and identification of potential blood biomarkers.Nature communications · 2025Article
- Management and monitoring strategies for severe cerebral malaria: a guide for the intensivist.Annals of intensive care · 2025Review
- Re-evaluating malarial retinopathy to improve its diagnostic accuracy in paediatric cerebral malaria: A retrospective study.PLoS medicine · 2025Article
- Potential of microRNAs as diagnostic markers for distinguishing malaria severity in samples from an Indian cohort.BMC infectious diseases · 2025Article
- Plasmodium falciparum egress disrupts endothelial junctions and activates JAK-STAT signaling in a microvascular 3D blood-brain barrier model.Nature communications · 2025Article
- Malaria associated pathogenesis of chronic kidney disease (MAP-CKD): a prospective study of children hospitalized with severe malaria.BMC nephrology · 2025Article
- Plasmodium knowlesi Infection Is Associated With Elevated Circulating Biomarkers of Brain Injury and Endothelial Activation.The Journal of infectious diseases · 2025Article
- Neuronal Damage in Murine Experimental Cerebral Malaria, Implications for Neuronal Repair and Sequelae.Cells · 2025Article
- Plasma Neutrophil Gelatinase-Associated Lipocalin as a Biomarker of Kidney Injury and Potential Predictor of Hypoxic Brain Injury in Severe Plasmodium falciparum Malaria: Insights From India.Seminars in nephrology · 2025Review
- Cerebral manifestations of falciparum malaria in adults: more than meets the eye.Trends in parasitology · 2025Review
- Contribution of Magnetic Resonance Imaging Studies to the Understanding of Cerebral Malaria Pathogenesis.Pathogens (Basel, Switzerland) · 2024Review
- Liver Transplantation Reverses Hepatic Myelopathy in the Decompensated Phase of Cirrhosis: Case Report and Literature Review.Journal of clinical and translational hepatology · 2024Article
- Adult Cerebral Malaria: Acute and Subacute Imaging Findings, Long-term Clinical Consequences.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- MRI-Based Brain Volume Scoring in Cerebral Malaria Is Externally Valid and Applicable to Lower-Resolution Images.AJNR. American journal of neuroradiology · 2024Article
- Sudden Onset of Coma and Fulminant Progression to Brain Death in a 48-Year-Old Male With Cerebral Malaria.Case reports in critical care · 2024Article
- Unravelling mysteries at the perivascular space: a new rationale for cerebral malaria pathogenesis.Trends in parasitology · 2024Review
- MicroRNAs in infectious diseases: potential diagnostic biomarkers and therapeutic targets.Clinical microbiology reviews · 2023Review
- Age-specific malaria vulnerability and transmission reservoir among children.Global pediatrics · 2023Review
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21 authors at 8 institutions in 7 countries.
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Abstract
backgroundCerebral malaria is a common presentation of severe Plasmodium falciparum infection and remains an important cause of death in the tropics. Key aspects of its pathogenesis are still incompletely understood, but severe brain swelling identified by magnetic resonance imaging (MRI) was associated with a fatal outcome in African children. In contrast, neuroimaging investigations failed to identify cerebral features associated with fatality in Asian adults.
methodsQuantitative MRI with brain volume assessment and apparent diffusion coefficient (ADC) histogram analyses were performed for the first time in 65 patients with cerebral malaria to compare disease signatures between children and adults from the same cohort, as well as between fatal and nonfatal cases.
resultsWe found an age-dependent decrease in brain swelling during acute cerebral malaria, and brain volumes did not differ between fatal and nonfatal cases across both age groups. In nonfatal disease, reversible, hypoxia-induced cytotoxic edema occurred predominantly in the white matter in children, and in the basal ganglia in adults. In fatal cases, quantitative ADC histogram analyses also demonstrated different end-stage patterns between adults and children: Severe hypoxia, evidenced by global ADC decrease and elevated plasma levels of lipocalin-2 and microRNA-150, was associated with a fatal outcome in adults. In fatal pediatric disease, our results corroborate an increase in brain volume, leading to augmented cerebral pressure, brainstem herniation, and death.
conclusionsOur findings suggest distinct pathogenic patterns in pediatric and adult cerebral malaria with a stronger cytotoxic component in adults, supporting the development of age-specific adjunct therapies.
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