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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Pediatric Neurology
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1466941

Variability of Day-to-Day Pulsatility Index Change in Children with Cerebral Malaria

Provisionally accepted
Jeremy Jordan Jeremy Jordan 1,2*Nicole O'brien Nicole O'brien 3Peng Li Peng Li 1Davin A. Musungufu Davin A. Musungufu 4Robert T. Ekandji Robert T. Ekandji 5Jean P. Mbaka Jean P. Mbaka 5Ludovic Mayindombe Ludovic Mayindombe 6Buba Giresse Buba Giresse 6Tusekile Phiri Tusekile Phiri 7Sylvester June Sylvester June 7Montfort B. Gushu Montfort B. Gushu 7Taty Tshimanga Taty Tshimanga 6Karin Reuter-Rice Karin Reuter-Rice 8
  • 1 University of Alabama at Birmingham, Birmingham, United States
  • 2 Children's of Alabama, Birmingham, Alabama, United States
  • 3 Nationwide Children's Hospital, Columbus, Ohio, United States
  • 4 Centre Medicale Evangelique, Bunia, Democratic Republic of Congo
  • 5 Universite des Sciences et des Technologie de Lodja, Lodja, Democratic Republic of Congo
  • 6 Hopital Pediatrique de Kalembe Lembe, Universite De Kinshasa, Kimwenza, Lembe, Democratic Republic of Congo
  • 7 Queen Elizabeth Central Hospital, Blantyre, Malawi
  • 8 Duke University, Durham, North Carolina, United States

The final, formatted version of the article will be published soon.

    Cerebral malaria (CM) is a devastating disease and better understanding of etiologies of the resulting neurologic injury is needed. The purpose of this study is to describe the day-to-day (DTD) pulsatility index (PI) change measured by transcranial doppler ultrasound (TCD), a novel measure of cerebral and vascular changes, in children with CM. A retrospective analysis of 122 children in sub-Saharan Africa with CM and 3 or more sequential TCD measurements was performed. Variability of DTD PI change was calculated as a measure of changes in vasculature overtime. Neurologic outcome was determined by the Pediatric Cerebral Performance Category (PCPC) score, a measure of neurologic function. Of the 122 participants, 77.9% had a good neurologic outcome (no neurologic sequelae), and 22.1% had a poor outcome (neurologic sequelae or died). Patients who had a poor neurologic outcome had higher levels of variability of DTD PI change in the right middle cerebral artery (MCA) (0.14±0.21) and left MCA (0.17±0.41) compared to those who had a good neurologic outcome (0.1±0.1 and 0.11±0.19, respectively). A higher variability of both left and right MCA DTD PI change was also associated with higher brain volume assessed through neuroimaging. Variability of DTD PI change may provide early prognostic information regarding PCPC outcomes and brain volume changes seen in CM patients. Expanded research on pathophysiologic contributors to variability of DTD PI changes in children with CM is warranted.

    Keywords: Ultrasonography, Doppler, Transcranial1, Cerebral Malaria2, Cerebral Vasculature3, Pediatrics4, Pulsatility Index5 JJ -Conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, formal analysis, project administration, resources, writing -original draft, writingreview & editing, NO -Conceptualization, data curation, investigation, methodology, data curation resources, writing -original draft, writing -review & editing, PL -methodology, formal analysis, writing -review & editing

    Received: 18 Jul 2024; Accepted: 21 Oct 2024.

    Copyright: © 2024 Jordan, O'brien, Li, Musungufu, Ekandji, Mbaka, Mayindombe, Giresse, Phiri, June, Gushu, Tshimanga and Reuter-Rice. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jeremy Jordan, University of Alabama at Birmingham, Birmingham, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.