{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T05:40:03Z","timestamp":1780465203068,"version":"3.54.1"},"reference-count":73,"publisher":"American Association for the Advancement of Science (AAAS)","issue":"713","content-domain":{"domain":["www.science.org"],"crossmark-restriction":true},"short-container-title":["Sci. Transl. Med."],"published-print":{"date-parts":[[2023,9,13]]},"abstract":"<jats:p>\n            Brain swelling is associated with death from cerebral malaria, but it is unclear whether brain swelling is caused by cerebral edema or vascular congestion\u2014two pathological conditions with distinct effects on tissue hemoglobin concentrations. We used near-infrared spectroscopy (NIRS) to noninvasively study cerebral microvascular hemoglobin concentrations in 46 Malawian children with cerebral malaria. Cerebral malaria was defined by the presence of the malaria parasite\n            <jats:italic>Plasmodium falciparum<\/jats:italic>\n            on a blood smear, a Blantyre coma score of 2 or less, and retinopathy. Children with uncomplicated malaria (\n            <jats:italic>n<\/jats:italic>\n            = 33) and healthy children (\n            <jats:italic>n<\/jats:italic>\n            = 29) were enrolled as comparators. Cerebral microvascular hemoglobin concentrations were higher among children with cerebral malaria compared with those with uncomplicated malaria [median (25th, 75th): 145.2 (95.2, 190.0) \u03bcM versus 82.9 (65.7, 105.4) \u03bcM,\n            <jats:italic>P<\/jats:italic>\n            = 0.008]. Cerebral microvascular hemoglobin concentrations correlated with brain swelling score determined by MRI (\n            <jats:italic>r<\/jats:italic>\n            = 0.37,\n            <jats:italic>P<\/jats:italic>\n            = 0.03). Fluctuations in cerebral microvascular hemoglobin concentrations over a 30-min time period were characterized using detrended fluctuation analysis (DFA). DFA determined self-similarity of the cerebral microvascular hemoglobin concentration signal to be lower among children with cerebral malaria compared with those with uncomplicated malaria [0.63 (0.54, 0.70) versus 0.91 (0.82, 0.94),\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.0001]. The lower self-similarity of the hemoglobin concentration signal in children with cerebral malaria suggested impaired regulation of cerebral blood flow. The elevated cerebral tissue hemoglobin concentration and its correlation with brain swelling suggested that excess blood volume, potentially due to vascular congestion, may contribute to brain swelling in cerebral malaria.\n          <\/jats:p>","DOI":"10.1126\/scitranslmed.adh4293","type":"journal-article","created":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T17:58:39Z","timestamp":1694627919000},"update-policy":"https:\/\/doi.org\/10.34133\/aaas_crossmark","source":"Crossref","is-referenced-by-count":8,"title":["Increased brain microvascular hemoglobin concentrations in children with cerebral malaria"],"prefix":"10.1126","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5318-219X","authenticated-orcid":true,"given":"Rachel L.","family":"Smith","sequence":"first","affiliation":[{"name":"Physiology Unit, Laboratory of Malaria and Vector Research, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Rockville, MD, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6483-3795","authenticated-orcid":true,"given":"Allison K.","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Physiology Unit, Laboratory of Malaria and Vector Research, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Rockville, MD, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3456-3971","authenticated-orcid":true,"given":"Carol A.","family":"Rowley","sequence":"additional","affiliation":[{"name":"Physiology Unit, Laboratory of Malaria and Vector Research, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Rockville, MD, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8312-8661","authenticated-orcid":true,"given":"Amit","family":"Khandhadia","sequence":"additional","affiliation":[{"name":"Infrared Imaging and Thermometry Unit, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander M.","family":"Gorbach","sequence":"additional","affiliation":[{"name":"Infrared Imaging and Thermometry Unit, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0119-804X","authenticated-orcid":true,"given":"Yamikani","family":"Chimalizeni","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Central Hospital and Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7416-3986","authenticated-orcid":true,"given":"Terrie E.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Central Hospital and Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi."},{"name":"Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9859-9549","authenticated-orcid":true,"given":"Karl","family":"Seydel","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Central Hospital and Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi."},{"name":"Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4940-3305","authenticated-orcid":true,"given":"Hans C.","family":"Ackerman","sequence":"additional","affiliation":[{"name":"Physiology Unit, Laboratory of Malaria and Vector Research, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Rockville, MD, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"221","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1203\/PDR.0b013e3181eee738"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1400116"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/mSphere.00193-17"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.76.3.219"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2990.1999.00188.x"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7519(99)00049-1"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir812"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2014.00155"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.11.6.583"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2014.00349"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X15617172"},{"key":"e_1_3_2_13_2","doi-asserted-by":"crossref","unstructured":"A.\u00a0Y.\u00a0Denault M.\u00a0Shaaban-Ali A.\u00a0Cournoyer A.\u00a0Benkreira T.\u00a0Mailhot Near-infrared spectroscopy in Neuromonitoring Techniques H.\u00a0Prabhakar Ed. (Academic Press 2018) pp.\u00a0179\u2013233.","DOI":"10.1016\/B978-0-12-809915-5.00007-3"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.09-4940"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1364\/JOSAA.4.000423"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.929199"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0245291"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2016.04.002"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.1992.67"},{"key":"e_1_3_2_20_2","first-page":"H1829","article-title":"Vasomotion of basilar arteries in vivo","volume":"258","author":"Fujii K.","year":"1990","unstructured":"K.\u00a0Fujii, D. D.\u00a0Heistad, F. M.\u00a0Faraci, Vasomotion of basilar arteries in vivo. Am. J.\u00a0Physiol. 258, H1829\u2013H1834 (1990).","journal-title":"Am. J.\u00a0Physiol."},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1006\/nimg.1996.0069"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1992.76.3.0415"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3940(96)12611-2"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1159\/000115278"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1113\/JP278710"},{"key":"e_1_3_2_26_2","first-page":"H233","article-title":"Transfer function analysis of dynamic cerebral autoregulation in humans","volume":"274","author":"Zhang R.","year":"1998","unstructured":"R.\u00a0Zhang, J. H.\u00a0Zuckerman, C. A.\u00a0Giller, B. D.\u00a0Levine, Transfer function analysis of dynamic cerebral autoregulation in humans. Am. J.\u00a0Physiol. 274, H233\u2013H241 (1998).","journal-title":"Am. J.\u00a0Physiol."},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1006\/nimg.2000.0657"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2010.06.001"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.577320"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-008-9140-5"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2018.00117"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2013.03.065"},{"key":"e_1_3_2_33_2","doi-asserted-by":"crossref","unstructured":"P. Castiglioni M.\u00a0Di Rienzo A.\u00a0Faini Self-similarity and detrended fluctuation analysis of cardiovascular signals in Complexity and Nonlinearity in Cardiovascular Signals R.\u00a0Barbieri E.\u00a0P.\u00a0Scilingo G.\u00a0Valenza Eds. (Springer International Publishing 2017) pp.\u00a0197\u2013232.","DOI":"10.1007\/978-3-319-58709-7_7"},{"key":"e_1_3_2_34_2","doi-asserted-by":"crossref","unstructured":"R.\u00a0L.\u00a0Armentano W.\u00a0Legnani L.\u00a0J.\u00a0Cymberknop Fractal Analysis of Cardiovascular Signals Empowering the Bioengineering Knowledge (IntechOpen 2017).","DOI":"10.5772\/67784"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2012.00450"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-4371(01)00144-3"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1103\/PhysRevE.49.1685"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2019.00270"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1063\/5.0011823"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.physleta.2004.06.070"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2008.2001286"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000790"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-017-0421-8"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-31685-y"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-021-04681-w"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0035-9203(00)90300-6"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2006.75.790"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2008.06.014"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1103\/PhysRevE.65.041107"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2018.07.075"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12936-022-04163-0"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awu001"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3035"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002340050321"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198202113060601"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)91638-B"},{"key":"e_1_3_2_57_2","first-page":"59","article-title":"Cerebral malaria in children. Comparative study between heparin, dexamethasone and placebo","volume":"31","author":"Rampengan T.","year":"1991","unstructured":"T.\u00a0Rampengan, Cerebral malaria in children. Comparative study between heparin, dexamethasone and placebo. Paediatr. Indones. 31, 59\u201366 (1991).","journal-title":"Paediatr. Indones."},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1647"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199903000-00047"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.1254"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1098\/rsif.2015.1027"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4614-4989-8_15"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.1016\/0887-8994(96)00115-4"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrn3475"},{"key":"e_1_3_2_65_2","first-page":"441","article-title":"Clinical features and prognostic indicators in paediatric cerebral malaria: A study of 131 comatose malawian children","volume":"71","author":"Molyneux M. E.","year":"1989","unstructured":"M. E.\u00a0Molyneux, T. E.\u00a0Taylor, J. J.\u00a0Wirima, A.\u00a0Borgsteinj, Clinical features and prognostic indicators in paediatric cerebral malaria: A study of 131 comatose malawian children. Q.\u00a0J.\u00a0Med. 71, 441\u2013459 (1989).","journal-title":"Q.\u00a0J.\u00a0Med."},{"key":"e_1_3_2_66_2","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12313_2"},{"key":"e_1_3_2_67_2","doi-asserted-by":"publisher","DOI":"10.1002\/bmc.3548"},{"key":"e_1_3_2_68_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiw452"},{"key":"e_1_3_2_69_2","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/33\/12\/008"},{"key":"e_1_3_2_70_2","doi-asserted-by":"publisher","DOI":"10.1021\/ac60214a047"},{"key":"e_1_3_2_71_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00068.2013"},{"key":"e_1_3_2_72_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31829e6ed5"},{"key":"e_1_3_2_73_2","doi-asserted-by":"crossref","unstructured":"T. de Waal Handbook of Statistical Data Editing and Imputation (Wiley 2011).","DOI":"10.1002\/9780470904848"},{"key":"e_1_3_2_74_2","doi-asserted-by":"publisher","DOI":"10.1613\/jair.953"}],"container-title":["Science Translational Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.science.org\/doi\/pdf\/10.1126\/scitranslmed.adh4293","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T17:55:06Z","timestamp":1705427706000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.science.org\/doi\/10.1126\/scitranslmed.adh4293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,13]]},"references-count":73,"journal-issue":{"issue":"713","published-print":{"date-parts":[[2023,9,13]]}},"alternative-id":["10.1126\/scitranslmed.adh4293"],"URL":"https:\/\/doi.org\/10.1126\/scitranslmed.adh4293","relation":{},"ISSN":["1946-6234","1946-6242"],"issn-type":[{"value":"1946-6234","type":"print"},{"value":"1946-6242","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,13]]},"assertion":[{"value":"2023-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"eadh4293"}}