Cognitive deficits associated with frontal‐lobe infarction in children with sickle cell disease

Abstract

This studs examined the cognitive manifestations of frontallobe 'hfarction in a population of children with sickle cell disease ( S O ) . Forty-one patients with SCD underwent MRI.

White Matter Damage in Asymptomatic Patients with Sickle Cell Anemia: Screening with Diffusion Tensor Imaging

“…Ischemic injury to the brain is one of the most devastating complications of SCA, with overt stroke occurring at an overall prevalence of 5% 1 and subclinical infarction occurring in 24%-35% of children on screening MR imaging. 2 While several studies have demonstrated neurocognitive deficits in the presence of overt [3][4][5] and silent stroke, [6][7][8] recent studies of large numbers of neurologically asymptomatic children and adults with SCA have demonstrated that cognitive impairment occurs even in the absence of brain abnormalities on conventional MR imaging. [9][10][11][12] Even though the method of neurocognitive assessment varied in these studies, the shared evidence supports both global IQ deficits, as well as domain specific deficits, in executive function and visual-spatial memory.…”

Neurological Complications and MRI

“…Some executive function deficits have been linked specifically to the presence of frontal lobe lesions [127,129,134], including one cognitive screening study finding the Test of Variables of Attention task was sensitive and specific in identifying 86% of children with SCI [135]. Patients with no evidence of SCI were found to have deficits in visuomotor functions compared to siblings [127,129], whereas other studies found no differences in sustained visual attention [92], working memory [123] or set-shifting [68]. A study of neurologically intact adults with SCD showed deficits in processing speed, working memory and other executive functions compared to controls [136].…”

“…Although it was thought that rates plateau in childhood, there is now evidence of new SCI in older adolescence and adulthood [1,67]. In the London cohort followed from the mid-1990s [68], 30% (3/10 patients) were found to have new SCI after the age of 14, 17 and 21 years, respectively (Figures 2 and 3). The SIT trial showed that in children aged 5-14 years with SCI, regular blood transfusion reduced the risk of reinfarction, both overt (clinical stroke) and silent [62].…”

“…A comprehensive systematic review published in 2007 [126] found that 11 out of 13 studies showed executive function and attention were impaired in children with SCD, in domains such as sustained attention [127][128][129], cognitive flexibility [68,130] and working memory [64,68,123,127,[131][132][133]. Some executive function deficits have been linked specifically to the presence of frontal lobe lesions [127,129,134], including one cognitive screening study finding the Test of Variables of Attention task was sensitive and specific in identifying 86% of children with SCI [135].…”

Blood Cell Membrane Omega-3 ( n -3) Fatty Acid Abnormality and Supplementation in Patients with Sickle Cell Anemia

“…Clinical stroke with focal signs lasting more than 24 h is more common in children (Earley et al, 1998). Regardless of brain structural abnormalities, children with sickle disease with or without a history of overt stroke tend to have lower cognitive ability (Hogan et al, 2006;Noll et al, 2001;Watkins et al, 1998), andocular (Elagouz et al, 2010;Nagpal et al, 1977) and ophthalmic (Babalola and Wambebe, 2005;To and Nadel, 1991) complications.…”