Associations of transcranial doppler velocity, age, and gender with cognitive function in children with sickle cell anemia in Nigeria

Prussien, Kemar V; Salihu, Auwal; Abdullahi, Shehu U.; Galadanci, Najibah A.; Bulama, Khadija; Belonwu, Raymond; Kirkham, Fenella J.; Yarboi, Janet; Bemis, Heather; DeBaun, Michael R.; Compas, Bruce E.

doi:10.1080/09297049.2018.1526272

Cited by 18 publications

(29 citation statements)

References 45 publications

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“…Cognitive impairment markedly impairs the quality of life, diminishes socioeconomic state, and interferes with school performance as well as patient's compliance to medications [22]. Neurocognitive deficits in SCD have been described in several studies [6,8,11]. Most of these studies were done in developed countries and there is very little literature on this complication in SCD patients from Africa.…”

Section: Discussionmentioning

confidence: 99%

“…Cognitive dysfunction has been the focus of attention of many researchers [8,9], due to their direct impact on many aspects of the human life including physical, mental and psychological well-being as well as the quality of life the person leads.…”

Section: Introductionmentioning

confidence: 99%

“…SCD patients underperform in diversity of methods used to measure the cognitive abilities, when compared to the normal counterparts, in the areas of verbal performance, memory, language and executive function. Also, school age children with SCD underachieve in the academic tests for reading, writing and math [8,10,11] .…”

Section: Introductionmentioning

confidence: 99%

“…In some cases, cognitive disturbances accompany overt and/or silent brain infarcts, while other sickle children develop cognitive impairment with no obvious brain insult [12]. Suggested other predisposing factors are: persistent lower level of hemoglobin with the resulting chronic hypoxia [10], chronic inflammatory conditions with elevated level of inflammatory markers as LDH [13], as well as lower socio-economic-state [8].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and risk factors of cognitive impairment in children with sickle cell disease in Egypt

et al. 2021

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Little is known about cognitive impairment in patients with sickle cell disease in Africa. This study aimed to assess cognitive impairment and identify possible risk factors in patients with sickle cell disease in Egypt. This study was conducted at Cairo University Children Hospital. Patients with sickle cell disease, between ages of 6-20 years were enrolled. Cognitive ability was tested using the Stanford Binet intelligence quotient (IQ) test, fourth edition. Transcranial Doppler, magnetic resonance imaging and magnetic resonance angiography of the brain were performed within a week of the IQ test. Among the 40 enrolled patients, 55% had a Full Scale IQ at least 1 standard deviation below the mean, and 27.5% had an IQ 2 standard deviations below the mean. High lactate dehydrogenase was significantly associated with low IQ (p = 0.004). In univariate analyses, IQ was significantly correlated with older age (p = 0.025), high lactate dehydrogenase (p = 0.008) and older age at the start of hydroxyurea (p = 0.025). Impaired cognition is prevalent among sickle cell disease patients. Early initiation of hydroxyurea therapy, which should also reduce hemolysis and lactate dehydrogenase, may be a simple measure to preserve mental abilities in these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence and risk factors of cognitive impairment in children with sickle cell disease in Egypt

et al. 2021

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“…Notably, MAC conditioning and calcineurin inhibitors come with increased risks of neurotoxicity 6 . Despite the fact that over 1000 transplants have been performed for SCD, long-term outcomes other than survival and graft failure remain poorly described 1,3. The primary risk factors for cognitive impairment in childhood SCD include chronic anemia, systemic ischemia, silent cerebral infarcts, and overt strokes 7,8 . While the incidence of overt stroke is decreasing due to primary stroke prevention strategies such as Transcranial Doppler (TCD) screening, transfusion therapy, and hydroxyurea, cerebrovascular compromise is still common and up to 40% of children and adolescents have MRI abnormalities, primarily in the frontal lobe 9,10 .…”

Section: Introductionmentioning

confidence: 99%

Neuropsychological, Behavioral, and Quality of Life Outcomes in Children and Adolescents with Sickle Cell Disease Treated with Nonmyeloablative Matched Sibling Donor Hematopoietic Cell Transplantation: A case series.

Fay‐McClymont

Monagel

Singh

et al. 2022

Preprint

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Background/Objectives. Despite advances in the treatment of sickle cell disease (SCD), cerebrovascular and cognitive consequences can be lifelong. Hematopoietic cell transplantation (HCT) is an established curative therapy and recent studies have demonstrated efficacy with reduced toxicity nonmyeloblative (NMA) regimens, but little is known about neuropsychological outcomes. The objective of this study was to describe neuropsychological, behavioral, and quality of life outcomes with medical correlates in children with SCD who received an NMA matched sibling donor (MSD) HCT. Design/Methods. This retrospective cohort analysis of nine patients with hemoglobin SS SCD underwent MSD HCT using the National Institutes of Health (NIH) NMA protocol. Results. Mean full scale intellectual functioning (FSIQ) was average pre-HCT (FSIQ=92.1, SD 9.0; n=8) and 2 years post-HCT (mean FSIQ=96.6; SD 11.1; N=9). Neuropsychological functioning was largely average across all cognitive domains. Moderate improvements were seen in processing speed and verbal memory (Cohen’s d=0.50-0.57) post-HCT, and declines occurred in measures of attention and fine motor speed and dexterity (Cohen’s d=0.70-0.81). Parents reported improved quality of life (Cohen’s d=0.91), less impact of SCD on their family, and less worry about their child’s future (Cohen’s d=1.44). Exploratory analysis showed relationships between pre-HCT hemoglobin (r=0.74, p<0.05) and creatinine (r=-0.75, p<0.01) with cognitive functioning, and a positive relationship between processing speed and time post-HCT (r=0.73). Conclusion. Neuropsychological functioning in a sample of children and adolescents treated identically with NMA MSD HCT remained stable or improved in most cognitive domains, and improvements in quality of life and family functioning were observed.

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Dementia in Africa: Current evidence, knowledge gaps, and future directions

Akinyemi

Yaria

Ojagbemi

et al. 2021

Alzheimer's & Dementia

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In tandem with the ever-increasing aging population in low and middle-income countries, the burden of dementia is rising on the African continent. Dementia prevalence varies from 2.3% to 20.0% and incidence rates are 13.3 per 1000 person-years with increasing mortality in parts of rapidly transforming Africa. Differences in nutrition, cardiovascular factors, comorbidities, infections, mortality, and detection likely contribute to lower incidence. Alzheimer's disease, vascular dementia, and human immunodeficiency virus/acquired immunodeficiency syndrome-associated neurocognitive disorders are the most common dementia subtypes. Comprehensive longitudinal studies with robust methodology and regional coverage would provide more reliable information. The apolipoprotein E (APOE) ε4 allele is most studied but has shown differential effects within African ancestry compared to Caucasian. More candidate gene and genome-wide association studies are needed to relate to dementia phenotypes.Validated culture-sensitive cognitive tools not influenced by education and language differences are critically needed for implementation across multidisciplinary groupings such as the proposed African Dementia Consortium.

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Associations of transcranial doppler velocity, age, and gender with cognitive function in children with sickle cell anemia in Nigeria

Cited by 18 publications

References 45 publications

Prevalence and risk factors of cognitive impairment in children with sickle cell disease in Egypt

Prevalence and risk factors of cognitive impairment in children with sickle cell disease in Egypt

Neuropsychological, Behavioral, and Quality of Life Outcomes in Children and Adolescents with Sickle Cell Disease Treated with Nonmyeloablative Matched Sibling Donor Hematopoietic Cell Transplantation: A case series.

Dementia in Africa: Current evidence, knowledge gaps, and future directions

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