Cognitive functioning and brain magnetic resonance imaging in children with sickle cell disease

F. Daniel Armstrong, Robert J. Thompson, M. D. Winfred Wang, M. D. Robert Zimmerman, H. Charles, M. D. Pegelow, M. D. Scott Miller, M. D. Franklin Moser, M. D. Jacqueline Bello, Anita Hurtig, Kerstin Vass

Research output: Contribution to journalArticle

292 Citations (Scopus)

Abstract

Objective. Brain magnetic resonance imaging (MRI) and neuropsychological evaluations were conducted to determine whether neuroradiographic evidence of infarct in children with sickle cell disease between ages 6 and 12 years would result in impairment in cognitive and academic functioning. Method and Design. Children enrolled in the Cooperative Study of Sickle Cell Disease were evaluated with brain MRI and neuropsychological evaluation. Completed studies were obtained for 194 children, 135 with HbSS. MRIs were categorized according to the presence of T2-weighted, high-intensity images suggestive of infarct and were further categorized on the basis of a clinical history of cerebrovascular accident (CVA). An abnormal MRI but no clinical history of CVA was classified as a silent infarct. Neuropsychological evaluations included assessment of both global intellectual functioning and specific academic and neuropsychological functions. Results. Central nervous system (CNS) abnormalities were identified on MRI in 17.9% of the children (22.2% of children homozygous for HbS), and a clinical history of CVA (N = 9, 4.6%) was identified in only children with HbSS disease. Subsequent analyses examined only children with HbSS. Children with a history of CVA performed significantly poorer than children with silent infarcts or no MRI abnormality on most neuropsychological evaluation measures. Children with silent infarcts on MRI performed significantly poorer than children with no MRI abnormality on tests of arithmetic, vocabulary, and visual motor speed and coordination. Conclusions. These results substantiate the importance of careful evaluation, educational planning, and medical intervention for CNS-related complications in children with sickle cell disease.

Original languageEnglish
Pages (from-to)864-870
Number of pages7
JournalPediatrics
Volume97
Issue number6 I
StatePublished - Jun 13 1996

Fingerprint

Sickle Cell Anemia
Magnetic Resonance Imaging
Brain
Stroke
Only Child
Central Nervous System
Nervous System Malformations
Psychomotor Performance
Language Tests

Keywords

  • cerebrovascular accident
  • cognitive deficits
  • infarcts
  • magnetic resonance imaging
  • neuropsychological
  • sickle cell disease
  • stroke

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Daniel Armstrong, F., Thompson, R. J., Winfred Wang, M. D., Robert Zimmerman, M. D., Charles, H., Pegelow, M. D., ... Vass, K. (1996). Cognitive functioning and brain magnetic resonance imaging in children with sickle cell disease. Pediatrics, 97(6 I), 864-870.

Cognitive functioning and brain magnetic resonance imaging in children with sickle cell disease. / Daniel Armstrong, F.; Thompson, Robert J.; Winfred Wang, M. D.; Robert Zimmerman, M. D.; Charles, H.; Pegelow, M. D.; Scott Miller, M. D.; Franklin Moser, M. D.; Jacqueline Bello, M. D.; Hurtig, Anita; Vass, Kerstin.

In: Pediatrics, Vol. 97, No. 6 I, 13.06.1996, p. 864-870.

Research output: Contribution to journalArticle

Daniel Armstrong, F, Thompson, RJ, Winfred Wang, MD, Robert Zimmerman, MD, Charles, H, Pegelow, MD, Scott Miller, MD, Franklin Moser, MD, Jacqueline Bello, MD, Hurtig, A & Vass, K 1996, 'Cognitive functioning and brain magnetic resonance imaging in children with sickle cell disease', Pediatrics, vol. 97, no. 6 I, pp. 864-870.
Daniel Armstrong F, Thompson RJ, Winfred Wang MD, Robert Zimmerman MD, Charles H, Pegelow MD et al. Cognitive functioning and brain magnetic resonance imaging in children with sickle cell disease. Pediatrics. 1996 Jun 13;97(6 I):864-870.
Daniel Armstrong, F. ; Thompson, Robert J. ; Winfred Wang, M. D. ; Robert Zimmerman, M. D. ; Charles, H. ; Pegelow, M. D. ; Scott Miller, M. D. ; Franklin Moser, M. D. ; Jacqueline Bello, M. D. ; Hurtig, Anita ; Vass, Kerstin. / Cognitive functioning and brain magnetic resonance imaging in children with sickle cell disease. In: Pediatrics. 1996 ; Vol. 97, No. 6 I. pp. 864-870.
@article{ee3548a2aa8c4d6f8d210105feab03e1,
title = "Cognitive functioning and brain magnetic resonance imaging in children with sickle cell disease",
abstract = "Objective. Brain magnetic resonance imaging (MRI) and neuropsychological evaluations were conducted to determine whether neuroradiographic evidence of infarct in children with sickle cell disease between ages 6 and 12 years would result in impairment in cognitive and academic functioning. Method and Design. Children enrolled in the Cooperative Study of Sickle Cell Disease were evaluated with brain MRI and neuropsychological evaluation. Completed studies were obtained for 194 children, 135 with HbSS. MRIs were categorized according to the presence of T2-weighted, high-intensity images suggestive of infarct and were further categorized on the basis of a clinical history of cerebrovascular accident (CVA). An abnormal MRI but no clinical history of CVA was classified as a silent infarct. Neuropsychological evaluations included assessment of both global intellectual functioning and specific academic and neuropsychological functions. Results. Central nervous system (CNS) abnormalities were identified on MRI in 17.9{\%} of the children (22.2{\%} of children homozygous for HbS), and a clinical history of CVA (N = 9, 4.6{\%}) was identified in only children with HbSS disease. Subsequent analyses examined only children with HbSS. Children with a history of CVA performed significantly poorer than children with silent infarcts or no MRI abnormality on most neuropsychological evaluation measures. Children with silent infarcts on MRI performed significantly poorer than children with no MRI abnormality on tests of arithmetic, vocabulary, and visual motor speed and coordination. Conclusions. These results substantiate the importance of careful evaluation, educational planning, and medical intervention for CNS-related complications in children with sickle cell disease.",
keywords = "cerebrovascular accident, cognitive deficits, infarcts, magnetic resonance imaging, neuropsychological, sickle cell disease, stroke",
author = "{Daniel Armstrong}, F. and Thompson, {Robert J.} and {Winfred Wang}, {M. D.} and {Robert Zimmerman}, {M. D.} and H. Charles and Pegelow, {M. D.} and {Scott Miller}, {M. D.} and {Franklin Moser}, {M. D.} and {Jacqueline Bello}, {M. D.} and Anita Hurtig and Kerstin Vass",
year = "1996",
month = "6",
day = "13",
language = "English",
volume = "97",
pages = "864--870",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "6 I",

}

TY - JOUR

T1 - Cognitive functioning and brain magnetic resonance imaging in children with sickle cell disease

AU - Daniel Armstrong, F.

AU - Thompson, Robert J.

AU - Winfred Wang, M. D.

AU - Robert Zimmerman, M. D.

AU - Charles, H.

AU - Pegelow, M. D.

AU - Scott Miller, M. D.

AU - Franklin Moser, M. D.

AU - Jacqueline Bello, M. D.

AU - Hurtig, Anita

AU - Vass, Kerstin

PY - 1996/6/13

Y1 - 1996/6/13

N2 - Objective. Brain magnetic resonance imaging (MRI) and neuropsychological evaluations were conducted to determine whether neuroradiographic evidence of infarct in children with sickle cell disease between ages 6 and 12 years would result in impairment in cognitive and academic functioning. Method and Design. Children enrolled in the Cooperative Study of Sickle Cell Disease were evaluated with brain MRI and neuropsychological evaluation. Completed studies were obtained for 194 children, 135 with HbSS. MRIs were categorized according to the presence of T2-weighted, high-intensity images suggestive of infarct and were further categorized on the basis of a clinical history of cerebrovascular accident (CVA). An abnormal MRI but no clinical history of CVA was classified as a silent infarct. Neuropsychological evaluations included assessment of both global intellectual functioning and specific academic and neuropsychological functions. Results. Central nervous system (CNS) abnormalities were identified on MRI in 17.9% of the children (22.2% of children homozygous for HbS), and a clinical history of CVA (N = 9, 4.6%) was identified in only children with HbSS disease. Subsequent analyses examined only children with HbSS. Children with a history of CVA performed significantly poorer than children with silent infarcts or no MRI abnormality on most neuropsychological evaluation measures. Children with silent infarcts on MRI performed significantly poorer than children with no MRI abnormality on tests of arithmetic, vocabulary, and visual motor speed and coordination. Conclusions. These results substantiate the importance of careful evaluation, educational planning, and medical intervention for CNS-related complications in children with sickle cell disease.

AB - Objective. Brain magnetic resonance imaging (MRI) and neuropsychological evaluations were conducted to determine whether neuroradiographic evidence of infarct in children with sickle cell disease between ages 6 and 12 years would result in impairment in cognitive and academic functioning. Method and Design. Children enrolled in the Cooperative Study of Sickle Cell Disease were evaluated with brain MRI and neuropsychological evaluation. Completed studies were obtained for 194 children, 135 with HbSS. MRIs were categorized according to the presence of T2-weighted, high-intensity images suggestive of infarct and were further categorized on the basis of a clinical history of cerebrovascular accident (CVA). An abnormal MRI but no clinical history of CVA was classified as a silent infarct. Neuropsychological evaluations included assessment of both global intellectual functioning and specific academic and neuropsychological functions. Results. Central nervous system (CNS) abnormalities were identified on MRI in 17.9% of the children (22.2% of children homozygous for HbS), and a clinical history of CVA (N = 9, 4.6%) was identified in only children with HbSS disease. Subsequent analyses examined only children with HbSS. Children with a history of CVA performed significantly poorer than children with silent infarcts or no MRI abnormality on most neuropsychological evaluation measures. Children with silent infarcts on MRI performed significantly poorer than children with no MRI abnormality on tests of arithmetic, vocabulary, and visual motor speed and coordination. Conclusions. These results substantiate the importance of careful evaluation, educational planning, and medical intervention for CNS-related complications in children with sickle cell disease.

KW - cerebrovascular accident

KW - cognitive deficits

KW - infarcts

KW - magnetic resonance imaging

KW - neuropsychological

KW - sickle cell disease

KW - stroke

UR - http://www.scopus.com/inward/record.url?scp=15844366370&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=15844366370&partnerID=8YFLogxK

M3 - Article

C2 - 8657528

AN - SCOPUS:15844366370

VL - 97

SP - 864

EP - 870

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 6 I

ER -