Browsing by Author "Sungura, Richard"

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A case-control study on the driving factors of childhood brain volume loss: What pediatricians must explore
(PLOS ONE, 2022-12-30) Sungura, Richard; Shirima, Gabriel; Spitsbergen, John; Mpolya, Emmanuel; Vianney, John-Mary
Background The brain volume loss also known as brain atrophy is increasingly observed among children in the course of performing neuroimaging using CT scan and MRI brains. While severe forms of brain volume loss are frequently associated with neurocognitive changes due to effects on thought processing speed, reasoning and memory of children that eventually alter their general personality, most clinicians embark themselves in managing the neurological manifestations of brain atrophy in childhood and less is known regarding the offending factors responsible for developing pre-senile brain atrophy. It was therefore the goal of this study to explore the factors that drive the occurrence of childhood brain volume under the guidance of brain CT scan quantitative evaluation. Methods This study was a case-control study involving 168 subjects with brain atrophy who were compared with 168 age and gender matched control subjects with normal brains on CT scan under the age of 18 years. All the children with brain CT scan were subjected to an intense review of their birth and medical history including laboratory investigation reports. Results Results showed significant and influential risk factors for brain atrophy in varying trends among children including age between 14-17(OR = 1.1), male gender (OR = 1.9), birth outside facility (OR = 0.99), immaturity (OR = 1.04), malnutrition (OR = 0.97), head trauma (OR = 1.02), maternal alcoholism (OR = 1.0), antiepileptic drugs & convulsive disorders (OR = 1.0), radiation injury (OR = 1.06), space occupying lesions and ICP (OR = 1.01) and birth injury/asphyxia (OR = 1.02). Conclusions Pathological reduction of brain volume in childhood exhibits a steady trend with the increase in pediatric age, with space occupying lesions & intracranial pressure being the most profound causes of brain atrophy.
Designing a novel method for brain volume quantification in investigating childhood brain atrophy and its functional effects
(NM-AIST, 2023-08) Sungura, Richard
Brain atrophy is a result of volume loss commonly indicated by brain parenchyma separation from calvarium on neuroimaging. The prevalence of childhood brain atrophy has not been determined globally. Despite sporadic reports, surprisingly little is known about the prevalence, risk factors, and functional effects, except in children's brains associated with epilepsy. There is currently no published alternative to high-priced automated technologies for reproducible manual quantification of brain volume. The primary aim of the study was to develop a manual diagonal brain fraction (DBF) formula for quantifying and grading brain volume to evaluate the effects of brain atrophy among children in the selected East African Countries-Northern Tanzania and Rwanda. Children in Northern Tanzania and Rwanda were analysed for evidence of brain atrophy using one-dimension linear radiological techniques and a newly developed formula, revealing a prevalence of 14.06% and 22% respectively. There were four distinct grades of disease severity. Head trauma, neonatal hypoxia, central nervous system infections, and increased intracranial pressure were cited as potential inducers of the atrophy. Significant alterations in brain waves were observed using EEG, which proved the altered functional implications of brain atrophy. These included, for example, decreased Delta/Alpha ratios (DAR) and higher beta activity. There is a negative relation between brain volume and IQ test scores in atrophied brain. Brain atrophy was also found to be strongly related to the presence of convulsive disorders. The results of this study conclude that, childhood brain atrophy is quite widespread among the population that was studied. The DBF is a straightforward technique for evaluating overall brain volume. Possible risks of brain atrophy in children include birth injury, central nervous system infection, head trauma and increased intracranial pressure. Beta activities such as Beta/Alpha ratio (BAR) may serve as brain atrophy bio-markers while the Delta/Alpha ratio (DAR) is trivial in brain atrophy settings. Damage to the brain's neurocognitive functions is reflected by lower-than-average IQ percentile score for age in atrophied brains. As a result, it is critical to develop methods of protecting children's mental health from potential risks.
The extended scope of neuroimaging and prospects in brain atrophy mitigation: a systematic review
(Elsevier B.V., 2020-08-15) Sungura, Richard; Onyambu, Callen; Mpolya, Emmanuel; Sauli, Elingarami; Vianney, John-Mary
Brain atrophy is a condition associated with a reduction of brain volume. It is a common manifestation of aging even though it occurs in some childhood conditions and carried forward to pre-senile middle age. There are several causes of brain atrophy resulting in different patterns of brain volume loss which spans from focal, global, central, cortical, and hemiatrophy. These conditions are commonly associated with other neurodegenerative changes that lead to different dysfunctions. Neuroimaging is critical for the diagnosis, evaluation of lesions and quantification of the atrophy. However, radiological quantification of brain volume is done by both automated and manual methods to study brains basing a wide variation of cranial sizes and shapes. A multidisciplinary approach is the future of brain atrophy management. An extended scope of knowledge beyond image interpretation is inevitable.
The focused quantitative EEG bio-marker in studying childhood atrophic encephalopathy
(Springer Nature Limited, 2022-08-04) Sungura, Richard; Shirima, Gabriel; Spitsbergen, John; Mpolya, Emmanuel; John‑Mary, Vianney
Although it is a normal involution process in advanced age, brain atrophy—also termed atrophic encephalopathy—can also occur prematurely in childhood as a consequential efect of brain tissues injury through trauma or central nervous system infection, though in both normal and premature occurrences this condition always presents with loss of volume relative to the skull. A common tool for the functional study of brain activities is an electroencephalogram, but analyses of this have reportedly identifed mismatches between qualitative and quantitative forms, particularly in the use of Delta-alpha ratio (DAR) indices, meaning that the values may be case dependent. The current study thus examines the value of Focused Occipital Beta-Alpha Ratio (FOBAR) as a modifed biomarker for evaluating brain functional changes resulting from brain atrophy. This cross-sectional design study involves 260 patients under 18 years of age. Specifcally, 207 patients with brain atrophy are compared with 53 control subjects with CT scan-proven normal brain volume. All the children underwent digital electroencephalography with brain mapping. Results show that alpha posterior dominant rhythm was present in 88 atrophic children and 44 controls. Beta as posterior dominant rhythm was present in an overwhelming 91.5% of atrophic subjects, with 0.009 p-values. The focused occipital Beta-alpha ratio correlated signifcantly with brain volume loss presented in diagonal brain fraction. The FOBAR and DAR values of the QEEG showed no signifcant correlation. This work concludes that QEEG cerebral dysfunctional studies may be etiologically and case dependent from the nature of the brain injury. Also, the focused Beta-alpha ratio of the QEEG is a prospective and potential biomarker of consideration in studying childhood atrophic encephalopathy