Prevalence and pattern of white matter abnormalities in adult patients referred for brain magnetic resonance imaging at Muhimbili national hospital

Abstract

Background: White matter Abnormalities are a worldwide problem. They are regularly encountered at health care facilities. Their occurrence varies globally with different rates based on age and sex. Women are generally affected more and with increasing age. White matter abnormalities are associated with an increased risk of stroke, cognitive decline, dementia and death hence affecting the quality of life of the affected individual.

MRI is widely used to diagnose white matter abnormalities which are brought about by a variety of causes. Little is known on MRI patterns of White matter abnormalities in our set up hence this study is aiming at determining the prevalence and pattern of white matter abnormalities using MRI in adult patients referred for brain MRI at Muhimbili National hospital. Objective: To determine the prevalence and pattern of white matter abnormalities by using Magnetic Resonance Imaging in adult patients referred for brain MRI at Muhimbili National Hospital. Materials and Methods: This was a descriptive cross sectional study which was conducted at radiology department, Muhimbili National Hospital from June to December 2016. Adults referred for brain Magnetic Resonance Imaging were included in this study. Consenting patients from 18 years of age were consecutively included in the research. Structured questionnaires were used for recording patients' demographics, clinical information and imaging findings obtained from brain MRI images. Data analysis was done using the Statistical Package for Social Sciences (SPSS) version 20. Statistical Association were done by using cross tabulations and Chi-square test was used to compare proportions. P value of < 0.05 was considered statistically significant. Results: This study included 144 adults aged from 18 to 84 years referred to the radiology department for brain Magnetic Resonance Imaging. The prevalence of White matter abnormalities was 47.9%. The proportion of adults with white matter abnormalities according to sex was 29(46.8%) for male and 40(48.8%) for female and it was increasing with age. The most frequent pattern of white matter abnormalities was periventricular (41.4%). The research showed significant correlation between hypertension and white matter abnormalities (P value =0.0001). There was also significant correlation between impaired cognitive function, depression and dementia and white matter abnormalities. Conclusion: Almost half of the studied individuals had white matter abnormalities. Majority of whom were patients aged 60 years and above. Female patients appear to be more affected than males by white matter abnormalities though this was not statistically significant in our study. Hypertension was a significant risk factor. Impaired cognitive function, depression and dementia are significantly related to white matter abnormality.

Recommendations: Large population based prospective studies should be carried out in order to be able to have results that could be generalized to the community. Not only that but also further studies are needed to explore various risk factors including genetic factors to underpin the development of white matter abnormalities in affected individuals. MRI is recommended to adult patients with impaired cognitive function to estimate the severity and monitor disease progress.