MSU researcher uses MRI to unlock how cerebral malaria damages brain

Building on a quarter century of work in Malawi, a Michigan State University researcher is traveling to neighboring Zambia to perform MRI scans on children newly diagnosed with cerebral malaria in hopes of unlocking how it damages the brain.

Michael Potchen, an associate professor in the Department of Radiology, has been awarded a three-year, $200,000 grant from the Dana Foundation, a private philanthropic organization supporting brain research through grants and public education. He is seeking to validate the findings of the Malawi MRI Research Team, which he leads with Terrie Taylor of MSU's College of Osteopathic Medicine.

Cerebral malaria affects more than three million children annually, primarily in sub-Saharan African nations such as Zambia and Malawi, Potchen said. Although drugs can quickly clear the malaria-causing parasite from children, up to 25 percent of those infected will die and almost one-third of survivors suffer long-term neurological problems, including epilepsy and behavioral problems.

"Even with millions of children being affected, we do not know how malaria damages the brain throughout the course of illness, especially in its earliest stages when therapeutic interventions might be most effective," he said. "While we have discovered very unique findings in Malawi during autopsies of children and using an MRI, those results cannot fully be verified using the Malawi MRI, which has a lower field strength and is therefore somewhat limited."

Using an MRI at the Cancer Disease Hospital in Zambia that is four times stronger than the machine used in Malawi, Potchen and his team will seek to validate initial evidence about how the disease damages the brain and produces epilepsy, behavioral disorders and severe cognitive and motor disabilities.

They will scan 25 children within three years, specifically looking at brain hemorrhaging, ischemia (lack of blood) in certain areas of the brain, whether the blood/brain barrier is intact and the severity of cerebral swelling.

"If confirmed, the findings will change the clinical care of cerebral malaria," said Potchen, who spends about four months a year in Africa. "This could lead to significant new approaches to prevent the disease or minimize its destructive effects in the brain."

The team will begin training with their counterparts at the Zambian hospital in January.

Taylor, who has been working in Malawi since the 1980s and spends six months a year there studying cerebral malaria, said MSU's collaborative approach in the region is crucial to making progress.

"The results to date from the Malawi MRI have greatly enhanced our understanding how malaria wreaks havoc in the brains of patients with cerebral malaria," she said. "Dr. Potchen's project represents an excellent opportunity to expand upon the Malawi findings."

Potchen said this particular project is bridging much of the work done by MSU researchers in Malawi and Zambia.

"Not only are we cooperating on work done by our staff, but this gives us the chance to build relationships among the health care communities in both nations on projects that are vital to both countries," he said.